7 commercial payer policies list K1004. 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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7 policies from 5 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of K1004 |
|---|---|---|
| Back Pain - Noninvasive Treatments | Apr 26, 2023 | Covered |
| Heating Devices | Nov 10, 2023 | Covered |
| Knee Arthroscopy / Osteoarthritis of the Knee | Nov 21, 2023 | Covered |
| Policy | Effective | Status of K1004 |
|---|---|---|
| Stationary Ultrasonic Diathermy Devices | Jun 15, 2026 | Covered |
| Policy | Effective | Status of K1004 |
|---|---|---|
| Stationary Ultrasonic Diathermy Devices | Jun 15, 2026 | Covered |
| Policy | Effective | Status of K1004 |
|---|---|---|
| Stationary Ultrasonic Diathermy Devices | Jun 15, 2026 | Covered |
| Policy | Effective | Status of K1004 |
|---|---|---|
| Stationary Ultrasonic Diathermy Devices | Jun 15, 2026 | Covered |