I42.1 coverage policies: Medicare and commercial payers

92 active Medicare policies list I42.1, and 4 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 I42.1

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 · 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

Cardiac Radionuclide Imaging

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L33457

Cardiac Radionuclide Imaging

JM · Effective Oct 1, 2015

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

Commercial payer policies listing I42.1

4 policies from 3 payers

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

Ambetter

Ambetter policies listing I42.1, with the code’s status in each
Policy	Effective	Status of I42.1
Concert Genetic Testing: CardiovascularPayerPolicy · AMBETTER-CONCERT-GENETIC-TESTING-CARDIOVASCULAR	Not recorded	Referenced
Pulmonary Function TestingPayerPolicy · AMBETTER-CP-MP-242	Not recorded	Covered

Anthem

Anthem policies listing I42.1, with the code’s status in each
Policy	Effective	Status of I42.1
External Ambulatory Cardiac MonitorsClinical Guideline · ANTHEM-CG-MED-40	Apr 15, 2026	Covered

Humana

Humana policies listing I42.1, with the code’s status in each
Policy	Effective	Status of I42.1