G50.0 coverage policies: Medicare and commercial payers

88 active Medicare policies list G50.0, and 18 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 G50.0

LCD · FIRST_COAST-L36767

Aortography and peripheral angiography

J9 · Effective Oct 31, 2016

LCD · PALMETTO-JJ-L37641

Continuous Peripheral Nerve Blocks (CPNB)

JJ · Effective Jan 29, 2018

LCD · PALMETTO-JM-L37641

Continuous Peripheral Nerve Blocks (CPNB)

JM · Effective Jan 29, 2018

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 · NOVITAS-JH-L35003

Intraoperative Neurophysiological Testing

JH · Effective Oct 1, 2015

LCD · NOVITAS-JL-L35003

Intraoperative Neurophysiological Testing

JL · Effective Oct 1, 2015

LCD · WPS-J5-L34623

Intraoperative Neurophysiological Testing

J5 · Effective Oct 1, 2015

LCD · WPS-J8-L34623

Intraoperative Neurophysiological Testing

J8 · Effective Oct 1, 2015

LCD · PALMETTO-JJ-L34424

Magnetic Resonance Angiography

Commercial payer policies listing G50.0

18 policies from 3 payers

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

Aetna

Showing 10 of 15 · All Aetna policies

Aetna policies listing G50.0, with the code’s status in each
Policy	Effective	Status of G50.0
Acupuncture and Dry NeedlingPayerPolicy · AETNA-CPB-0135	Apr 5, 2023	Covered
Attended Electroencephalographic (EEG) Video MonitoringPayerPolicy · AETNA-CPB-0322	Apr 28, 2023	Covered
CoblationPayerPolicy · AETNA-CPB-0475	Jul 12, 2023	Covered
Cold Laser and High-Power Laser TherapiesPayerPolicy · AETNA-CPB-0363	Feb 15, 2024	Covered
Cryoanalgesia and Therapeutic ColdPayerPolicy · AETNA-CPB-0297	Mar 16, 2023	Covered
Intra-oral Appliances for Headaches and Trigeminal NeuralgiaPayerPolicy · AETNA-CPB-0688	Dec 13, 2023

Policy	Effective	Status of G50.0
Implantation of Occipital, Supraorbital or Trigeminal Nerve Stimulation Devices (and Related Procedures)PayerPolicy · ANTHEM-SURG.00112	Oct 1, 2026	Not covered
Radiofrequency Neurolysis and Pulsed Radiofrequency Therapy for Trigeminal NeuralgiaClinical Guideline · ANTHEM-CG-SURG-89	Jul 1, 2026	Covered