I28.1 coverage policies: Medicare and commercial payers

39 active Medicare policies list I28.1, 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 I28.1

LCD · CGS-J15-L33959

Cardiac Catheterization and Coronary Angiography

J15 · 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 · 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 · 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 · PALMETTO-JJ-L37379

Echocardiography

JJ · Effective Sep 18, 2017

LCD · PALMETTO-JM-L37379

Echocardiography

JM · Effective Sep 18, 2017

LCD · NORIDIAN-JE-L34315

Electrocardiograms

Commercial payer policies listing I28.1

1 policy from 1 payer

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

Ambetter

Ambetter policies listing I28.1, with the code’s status in each
Policy	Effective	Status of I28.1
Pulmonary Function TestingPayerPolicy · AMBETTER-CP-MP-242	Not recorded	Covered