External Infusion Pumps
National · Effective Jan 25, 2026
1 active Medicare policy lists K0455, 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.
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National · Effective Jan 25, 2026
2 policies from 2 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of K0455 |
|---|---|---|
| Durable Medical Equipment and Orthotics and Prosthetics Guidelines | Not recorded | Covered |
| Policy | Effective | Status of K0455 |
|---|---|---|
| Cigna Medicare Advantage Durable Medical Equipment Code List | Jan 1, 2025 | Prior auth required |