I20.9 coverage policies: Medicare and commercial payers

62 active Medicare policies list I20.9, 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 I20.9

LCD · PALMETTO-JJ-L33457

Cardiac Radionuclide Imaging

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L33457

Cardiac Radionuclide Imaging

JM · Effective Oct 1, 2015

LCD · NGS-J6-L33557

Cardiac Catheterization and Coronary Angiography

J6 · Effective Oct 1, 2015

LCD · NGS-JK-L33557

Cardiac Catheterization and Coronary Angiography

JK · Effective Oct 1, 2015

LCD · CGS-J15-L33947

Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA)

J15 · Effective Oct 1, 2015

LCD · NGS-J6-L33559

Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA)

J6 · Effective Oct 1, 2015

LCD · NGS-JK-L33559

Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA)

JK · Effective Oct 1, 2015

LCD · PALMETTO-JJ-L33423

Cardiac Computed Tomography & Angiography (CCTA)

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L33423

Cardiac Computed Tomography & Angiography (CCTA)

JM · Effective Oct 1, 2015

LCD · FIRST_COAST-L38396

Commercial payer policies listing I20.9

3 policies from 1 payer

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

Anthem

Anthem policies listing I20.9, with the code’s status in each
Policy	Effective	Status of I20.9
Enhanced External Counterpulsation in the Outpatient SettingClinical Guideline · ANTHEM-CG-MED-86	Jan 6, 2026	Covered
External Ambulatory Cardiac MonitorsClinical Guideline · ANTHEM-CG-MED-40	Apr 15, 2026	Covered
Transmyocardial RevascularizationPayerPolicy · ANTHEM-SURG.00019	Jul 1, 2026	Covered