K50.00 coverage policies: Medicare and commercial payers

79 active Medicare policies list K50.00, and 23 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 K50.00

Free account. Policy pages stay open to everyone.

Medicare policies listing K50.00

LCD · NOVITAS-JH-L34914

Assays for Vitamins and Metabolic Function

JH · Effective Oct 1, 2015

LCD · NOVITAS-JL-L34914

Assays for Vitamins and Metabolic Function

JL · Effective Oct 1, 2015

LCD · WPS-J5-L34614

Colonoscopy and Sigmoidoscopy-Diagnostic

J5 · Effective Oct 1, 2015

LCD · WPS-J8-L34614

Colonoscopy and Sigmoidoscopy-Diagnostic

J8 · Effective Oct 1, 2015

LCD · CGS-J15-L34005

Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy

J15 · Effective Oct 1, 2015

LCD · PALMETTO-JJ-L34415

CT of the Abdomen and Pelvis

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L34415

CT of the Abdomen and Pelvis

JM · Effective Oct 1, 2015

LCD · NORIDIAN-JE-L34213

Diagnostic and Therapeutic Colonoscopy

JE · Effective Oct 1, 2015

LCD · NORIDIAN-JF-L34213

Diagnostic and Therapeutic Colonoscopy

JF · Effective Oct 1, 2015

LCD · FIRST_COAST-L33583

Diagnostic and Therapeutic Esophagogastroduodenoscopy

Commercial payer policies listing K50.00

23 policies from 5 payers

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

Aetna

Showing 10 of 13 · All Aetna policies

Aetna policies listing K50.00, with the code’s status in each
Policy	Effective	Status of K50.00
ADAMTS13 Assay for Thrombotic Thrombocytopenic Purpura (TTP)PayerPolicy · AETNA-CPB-0780	Oct 26, 2023	Covered
Analysis of Volatile Organic CompoundsPayerPolicy · AETNA-CPB-0717	Oct 3, 2023	Covered
Autologous Skeletal Myoblast/Mononuclear Bone Marrow Cell TransplantationPayerPolicy · AETNA-CPB-0599	Aug 30, 2023	Covered
Blood and Adipose Tissue Derived Products for Selected IndicationsPayerPolicy · AETNA-CPB-0784	Oct 26, 2023	Covered
Exhaled Breath TestsPayerPolicy · AETNA-CPB-0691	Sep 15, 2023	Covered
Extracorporeal Photochemotherapy (Photopheresis)PayerPolicy · AETNA-CPB-0241

Policy	Effective	Status of K50.00
Gamma Glutamyl Transferase TestingClinical Guideline · ANTHEM-CG-LAB-29	Jul 1, 2026	Covered
Laboratory Evaluation of Vitamin B12Clinical Guideline · ANTHEM-CG-LAB-19	Jan 6, 2026	Covered
Serum Iron TestingClinical Guideline · ANTHEM-CG-LAB-21	Apr 15, 2026	Covered
Therapeutic use of Stem Cells, Blood and Bone Marrow ProductsPayerPolicy · ANTHEM-TRANS.00035	Oct 1, 2026	Not covered
Vitamin D TestingClinical Guideline · ANTHEM-CG-LAB-11	Oct 1, 2026	Covered
Wireless Capsule Endoscopy for Gastrointestinal Imaging and the Patency CapsuleClinical Guideline · ANTHEM-CG-MED-70	Oct 1, 2026	Covered

Policy	Effective	Status of K50.00
Fecal Calprotectin TestingPayerPolicy · CIGNA-0121	Mar 15, 2026	Covered
Serum Folate and Red Blood Cell Folate TestingPayerPolicy · CIGNA-0567	Dec 15, 2025	Covered