G70.81 coverage policies: Medicare and commercial payers

72 active Medicare policies list G70.81, and 3 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 G70.81

LCD · PALMETTO-JJ-L34411

Blepharoplasty, Eyelid Surgery, and Brow Lift

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L34411

Blepharoplasty, Eyelid Surgery, and Brow Lift

JM · Effective Oct 1, 2015

LCD · PALMETTO-JJ-L33459

Computerized Axial Tomography (CT), Thorax

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L33459

Computerized Axial Tomography (CT), Thorax

JM · Effective Oct 1, 2015

LCD · FIRST_COAST-L34007

Immune Globulin

J9 · Effective Oct 1, 2015

LCD · NOVITAS-JH-L35093

Immune Globulin

JH · Effective Oct 1, 2015

LCD · NOVITAS-JL-L35093

Immune Globulin

JL · Effective Oct 1, 2015

LCD · NORIDIAN-JE-L34314

Immune Globulin Intravenous (IVIg)

JE · Effective Oct 1, 2015

LCD · NORIDIAN-JF-L34314

Immune Globulin Intravenous (IVIg)

JF · Effective Oct 1, 2015

LCD · PALMETTO-JJ-L34580

Intravenous Immunoglobulin (IVIG)

Commercial payer policies listing G70.81

3 policies from 3 payers

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

Aetna

Aetna policies listing G70.81, with the code’s status in each
Policy	Effective	Status of G70.81
Home Uterine Activity MonitoringPayerPolicy · AETNA-CPB-0127	Mar 22, 2023	Covered

Ambetter

Ambetter policies listing G70.81, with the code’s status in each
Policy	Effective	Status of G70.81
Pulmonary Function TestingPayerPolicy · AMBETTER-CP-MP-242	Not recorded	Covered

Cigna

Cigna policies listing G70.81, with the code’s status in each
Policy	Effective	Status of G70.81
Electrodiagnostic Testing (EMG/NCV)PayerPolicy · CIGNA-CPG129	Sep 15, 2026	Covered