G54.6 coverage policies: Medicare and commercial payers

36 active Medicare policies list G54.6, and 5 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 G54.6

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 · NORIDIAN-JE-L35456

Nerve Blockade for Treatment of Chronic Pain and Neuropathy

JE · Effective Oct 1, 2015

LCD · NORIDIAN-JF-L35456

Nerve Blockade for Treatment of Chronic Pain and Neuropathy

JF · Effective Oct 1, 2015

LCD · CGS-J15-L35897

Nerve Conduction Studies and Electromyography

J15 · Effective Oct 1, 2015

LCD · FIRST_COAST-L34859

Nerve Conduction Studies and Electromyography

J9 · Effective Oct 1, 2015

LCD · NGS-J6-L35098

Nerve Conduction Studies and Electromyography

J6 · Effective Oct 1, 2015

LCD · NGS-JK-L35098

Nerve Conduction Studies and Electromyography

JK · Effective Oct 1, 2015

LCD · NORIDIAN-JE-L36524

Nerve Conduction Studies and Electromyography

JE · Effective Jun 1, 2016

LCD · NORIDIAN-JF-L36524

Commercial payer policies listing G54.6

5 policies from 1 payer

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

Aetna

Aetna policies listing G54.6, with the code’s status in each
Policy	Effective	Status of G54.6
CoblationPayerPolicy · AETNA-CPB-0475	Jul 12, 2023	Covered
Cryoanalgesia and Therapeutic ColdPayerPolicy · AETNA-CPB-0297	Mar 16, 2023	Covered
Eye Movement Desensitization and Reprocessing (EMDR) TherapyPayerPolicy · AETNA-CPB-0583	Sep 7, 2023	Covered
Laser NeurolysisPayerPolicy · AETNA-CPB-0552	Jul 27, 2023	Covered
Motor Cortex StimulationPayerPolicy · AETNA-CPB-0755	Oct 6, 2023	Covered