J43.1 coverage policies: Medicare and commercial payers

41 active Medicare policies list J43.1, and 2 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.

Get free alerts for J43.1

Free account. Policy pages stay open to everyone.

Medicare policies listing J43.1

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 · NORIDIAN-JE-L34315

Electrocardiograms

JE · Effective Oct 1, 2015

LCD · NORIDIAN-JF-L34315

Electrocardiograms

JF · Effective Oct 1, 2015

LCD · PALMETTO-JJ-L34576

Laparoscopic Sleeve Gastrectomy for Severe Obesity

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L34576

Laparoscopic Sleeve Gastrectomy for Severe Obesity

JM · Effective Oct 1, 2015

LCD · NOVITAS-JH-L35049

Monitored Anesthesia Care

JH · Effective Oct 1, 2015

LCD · NOVITAS-JL-L35049

Monitored Anesthesia Care

JL · Effective Oct 1, 2015

LCD · FIRST_COAST-L33923

Noninvasive Ear or Pulse Oximetry For Oxygen Saturation

J9 · Effective Oct 1, 2015

LCD · NOVITAS-JH-L35434

Oximetry Services

Commercial payer policies listing J43.1

2 policies from 2 payers

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

Aetna

Aetna policies listing J43.1, with the code’s status in each
Policy	Effective	Status of J43.1
Alpha1-Proteinase InhibitorsPayerPolicy · AETNA-CPB-0145	Apr 25, 2023	Covered

Ambetter

Ambetter policies listing J43.1, with the code’s status in each
Policy	Effective	Status of J43.1
Pulmonary Function TestingPayerPolicy · AMBETTER-CP-MP-242	Not recorded	Covered