H90.A12 coverage policies: Medicare and commercial payers

23 active Medicare policies list H90.A12, and 1 commercial payer policy lists 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 H90.A12

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-L34424

Magnetic Resonance Angiography

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L34424

Magnetic Resonance Angiography

JM · Effective Oct 1, 2015

LCD · NOVITAS-JH-L34975

Neurophysiology Evoked Potentials (NEPs)

JH · Effective Oct 1, 2015

LCD · NOVITAS-JL-L34975

Neurophysiology Evoked Potentials (NEPs)

JL · Effective Oct 1, 2015

LCD · NOVITAS-JH-L35070

Speech - Language Pathology (SLP) Services: Communication Disorders

JH · Effective Oct 1, 2015

LCD · NOVITAS-JL-L35070

Speech - Language Pathology (SLP) Services: Communication Disorders

JL · Effective Oct 1, 2015

LCD · NGS-J6-L33580

Speech-Language Pathology

J6 · Effective Oct 1, 2015

LCD · NGS-JK-L33580

Speech-Language Pathology

Commercial payer policies listing H90.A12

1 policy from 1 payer

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

Anthem

Anthem policies listing H90.A12, with the code’s status in each
Policy	Effective	Status of H90.A12
Auditory Brainstem Responses (ABRs) and Evoked Otoacoustic Emissions (OAEs) for Hearing DisordersClinical Guideline · ANTHEM-CG-MED-49	Jul 1, 2026	Covered