I21.01 coverage policies: Medicare and commercial payers

106 active Medicare policies list I21.01, 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 I21.01

Showing 100 of 106

LCD · FIRST_COAST-L39492

Ambulatory Electrocardiograph (AECG) Monitoring

J9 · Effective Jun 11, 2023

LCD · NOVITAS-JH-L39490

Ambulatory Electrocardiograph (AECG) Monitoring

JH · Effective Jun 11, 2023

LCD · NOVITAS-JL-L39490

Ambulatory Electrocardiograph (AECG) Monitoring

JL · Effective Jun 11, 2023

LCD · FIRST_COAST-L33267

B-Type Natriuretic Peptide (BNP)

J9 · Effective Oct 1, 2015

LCD · CGS-J15-L33943

B-type Natriuretic Peptide (BNP) Testing

J15 · Effective Oct 1, 2015

LCD · NORIDIAN-JE-L35526

B-type Natriuretic Peptide (BNP) Testing

JE · Effective Oct 1, 2015

LCD · NORIDIAN-JF-L35526

B-type Natriuretic Peptide (BNP) Testing

JF · Effective Oct 1, 2015

LCD · PALMETTO-JJ-L34410

B-type Natriuretic Peptide (BNP) Testing

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L34410

B-type Natriuretic Peptide (BNP) Testing

JM · Effective Oct 1, 2015

LCD · PALMETTO-JJ-L33457

Commercial payer policies listing I21.01

3 policies from 2 payers

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

Anthem

Anthem policies listing I21.01, with the code’s status in each
Policy	Effective	Status of I21.01
Automated External Defibrillators for Home UseClinical Guideline · ANTHEM-CG-DME-55	Oct 1, 2026	Covered
Outpatient Glycated Hemoglobin and Protein TestingClinical Guideline · ANTHEM-CG-LAB-25	Jul 1, 2026	Covered

Ambetter

Ambetter policies listing I21.01, with the code’s status in each
Policy	Effective	Status of I21.01
Concert Genetic Testing: Toxicology and Pharmacogenetics Version BPayerPolicy · AMBETTER-CONCERT-GENETIC-TESTING-TOXICOLOGY-AND-PHARMACOGENETICS-VERSION-B	Not recorded	Referenced