I77.812 coverage policies: Medicare and commercial payers

25 active Medicare policies list I77.812, 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 I77.812

LCD · FIRST_COAST-L36767

Aortography and peripheral angiography

J9 · Effective Oct 31, 2016

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 · NOVITAS-JH-L35092

Diagnostic Abdominal Aortography and Renal Angiography

JH · Effective Oct 1, 2015

LCD · NOVITAS-JL-L35092

Diagnostic Abdominal Aortography and Renal Angiography

JL · Effective Oct 1, 2015

LCD · PALMETTO-JJ-L34424

Magnetic Resonance Angiography

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L34424

Magnetic Resonance Angiography

JM · Effective Oct 1, 2015

LCD · NGS-J6-L33633

Magnetic Resonance Angiography (MRA)

J6 · Effective Oct 1, 2015

LCD · NGS-JK-L33633

Magnetic Resonance Angiography (MRA)

JK · Effective Oct 1, 2015

LCD · WPS-J5-L35755

Non-Invasive Abdominal / Visceral Vascular Studies

Commercial payer policies listing I77.812

1 policy from 1 payer

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

Cigna

Cigna policies listing I77.812, with the code’s status in each
Policy	Effective	Status of I77.812
Transthoracic Echocardiography in AdultsPayerPolicy · CIGNA-0510	Sep 15, 2026	Covered