G61.89 coverage policies: Medicare and commercial payers

55 active Medicare policies list G61.89, 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 G61.89

LCD · WPS-J5-L34771

Immune Globulins

J5 · Effective Oct 1, 2015

LCD · WPS-J8-L34771

Immune Globulins

J8 · Effective Oct 1, 2015

LCD · CGS-J15-L35891

Intravenous Immune Globulin

J15 · Effective Oct 1, 2015

LCD · PALMETTO-JJ-L34580

Intravenous Immunoglobulin (IVIG)

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L34580

Intravenous Immunoglobulin (IVIG)

JM · Effective Oct 1, 2015

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 · PALMETTO-JJ-L37642

Nerve Blocks and Electrostimulation for Peripheral Neuropathy

JJ · Effective Jan 29, 2018

LCD · PALMETTO-JM-L37642

Nerve Blocks and Electrostimulation for Peripheral Neuropathy

JM · Effective Jan 29, 2018

LCD · CGS-J15-L35897

Nerve Conduction Studies and Electromyography

Commercial payer policies listing G61.89

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 G61.89, with the code’s status in each
Policy	Effective	Status of G61.89
Antibody Tests for Neurologic DiseasesPayerPolicy · AETNA-CPB-0340	Feb 15, 2024	Covered

Anthem

Anthem policies listing G61.89, with the code’s status in each
Policy	Effective	Status of G61.89
Therapeutic ApheresisClinical Guideline · ANTHEM-CG-MED-68	Apr 15, 2026	Covered