G47.419 coverage policies: Medicare and commercial payers

51 active Medicare policies list G47.419, and 2 commercial payer policies list it. See each policy's status for the code and its official source. Listing a code is not a coverage decision: read each policy’s source for the requirements that apply.

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Medicare policies listing G47.419

LCD · PALMETTO-JJ-L34417

CT of the Head

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L34417

CT of the Head

JM · Effective Oct 1, 2015

LCD · WPS-J5-L38528

Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea

J5 · Effective Jun 14, 2020

LCD · WPS-J8-L38528

Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea

J8 · Effective Jun 14, 2020

LCD · NORIDIAN-JE-L36551

MolDX: HLA-DQB1*06:02 Testing for Narcolepsy

JE · Effective Sep 15, 2016

LCD · NORIDIAN-JF-L36551

MolDX: HLA-DQB1*06:02 Testing for Narcolepsy

JF · Effective Sep 15, 2016

LCD · PALMETTO-JJ-L36464

MolDX: HLA-DQB1*06:02 Testing for Narcolepsy

JJ · Effective Feb 15, 2016

LCD · PALMETTO-JM-L36464

MolDX: HLA-DQB1*06:02 Testing for Narcolepsy

JM · Effective Feb 15, 2016

LCD · NORIDIAN-JE-L37373

MRI and CT Scans of the Head and Neck

JE · Effective Oct 8, 2018

LCD · NORIDIAN-JF-L37373

Commercial payer policies listing G47.419

2 policies from 2 payers

Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.

Aetna

Aetna policies listing G47.419, with the code’s status in each
Policy	Effective	Status of G47.419
Eye Movement Desensitization and Reprocessing (EMDR) TherapyPayerPolicy · AETNA-CPB-0583	Sep 7, 2023	Covered

Ambetter

Ambetter policies listing G47.419, with the code’s status in each
Policy	Effective	Status of G47.419
Concert Genetic Testing: Toxicology and Pharmacogenetics Version BPayerPolicy · AMBETTER-CONCERT-GENETIC-TESTING-TOXICOLOGY-AND-PHARMACOGENETICS-VERSION-B	Not recorded	Referenced