G62.81 coverage policies: Medicare and commercial payers

52 active Medicare policies list G62.81, 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 G62.81

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-L34220

Lumbar MRI

JE · Effective Oct 1, 2015

LCD · NORIDIAN-JF-L34220

Lumbar MRI

JF · 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

J15 · Effective Oct 1, 2015

LCD · FIRST_COAST-L34859

Commercial payer policies listing G62.81

2 policies from 1 payer

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

Cigna

Cigna policies listing G62.81, with the code’s status in each
Policy	Effective	Status of G62.81
Electrodiagnostic Testing (EMG/NCV)PayerPolicy · CIGNA-CPG129	Sep 15, 2026	Covered
Serum Folate and Red Blood Cell Folate TestingPayerPolicy · CIGNA-0567	Dec 15, 2025	Covered