I69.323 coverage policies: Medicare and commercial payers

33 active Medicare policies list I69.323, 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 I69.323

LCD · CGS-J15-L38694

Computed Tomography Cerebral Perfusion Analysis (CTP)

J15 · Effective Nov 2, 2020

LCD · NGS-J6-L38667

Computed Tomography Cerebral Perfusion Analysis (CTP)

J6 · Effective Nov 1, 2020

LCD · NGS-JK-L38667

Computed Tomography Cerebral Perfusion Analysis (CTP)

JK · Effective Nov 1, 2020

LCD · NORIDIAN-JE-L38709

Computed Tomography Cerebral Perfusion Analysis (CTP)

JE · Effective Dec 13, 2020

LCD · NORIDIAN-JF-L38709

Computed Tomography Cerebral Perfusion Analysis (CTP)

JF · Effective Dec 13, 2020

LCD · PALMETTO-JJ-L38769

Computed Tomography Cerebral Perfusion Analysis (CTP)

JJ · Effective Feb 7, 2021

LCD · PALMETTO-JM-L38769

Computed Tomography Cerebral Perfusion Analysis (CTP)

JM · Effective Feb 7, 2021

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 · NORIDIAN-JE-L37373

Commercial payer policies listing I69.323

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 I69.323, with the code’s status in each
Policy	Effective	Status of I69.323
Altered Auditory Feedback Devices for Fluency DisordersPayerPolicy · ANTHEM-DME.00030	Jul 1, 2026	Not covered