G93.2 coverage policies: Medicare and commercial payers

40 active Medicare policies list G93.2, and 7 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 G93.2

LCD · NOVITAS-JH-L35022

Bariatric Surgical Management of Morbid Obesity

JH · Effective Oct 1, 2015

LCD · NOVITAS-JL-L35022

Bariatric Surgical Management of Morbid Obesity

JL · Effective Oct 1, 2015

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 · PALMETTO-JJ-L34576

Laparoscopic Sleeve Gastrectomy for Severe Obesity

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L34576

Laparoscopic Sleeve Gastrectomy for Severe Obesity

JM · Effective Oct 1, 2015

LCD · NORIDIAN-JE-L37373

MRI and CT Scans of the Head and Neck

JE · Effective Oct 8, 2018

LCD · NORIDIAN-JF-L37373

MRI and CT Scans of the Head and Neck

JF · Effective Oct 8, 2018

LCD · PALMETTO-JJ-L35048

Nerve Conduction Studies and Electromyography

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L35048

Nerve Conduction Studies and Electromyography

Commercial payer policies listing G93.2

7 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 G93.2, with the code’s status in each
Policy	Effective	Status of G93.2
Extended OphthalmoscopyPayerPolicy · AETNA-CPB-0767	Oct 26, 2023	Covered
Optic Nerve and Retinal Imaging MethodsPayerPolicy · AETNA-CPB-0344	May 17, 2023	Covered
Optic Nerve Decompression SurgeryPayerPolicy · AETNA-CPB-0415	Jun 27, 2023	Covered

Ambetter

Ambetter policies listing G93.2, with the code’s status in each
Policy	Effective	Status of G93.2
Fundus PhotographyPayerPolicy · AMBETTER-CP-VP-29	Not recorded	Covered
Visual Field TestingPayerPolicy · AMBETTER-CP-VP-63	Not recorded

Policy	Effective	Status of G93.2
Fundus PhotographyClinical Guideline · ANTHEM-CG-MED-47	Apr 15, 2026	Covered
Venous Angioplasty with or without Stent Placement or Venous Stenting AloneClinical Guideline · ANTHEM-CG-SURG-106	Apr 15, 2026	Covered