K51.90 coverage policies: Medicare and commercial payers

57 active Medicare policies list K51.90, 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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Medicare policies listing K51.90

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-L34454

Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L34454

Colonoscopy/Sigmoidoscopy/Proctosigmoidoscopy

JM · 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 · FIRST_COAST-L33671

Diagnostic Colonoscopy

Commercial payer policies listing K51.90

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 K51.90, with the code’s status in each
Policy	Effective	Status of K51.90
Homocysteine TestingPayerPolicy · AETNA-CPB-0763	Oct 26, 2023	Covered

Cigna

Cigna policies listing K51.90, with the code’s status in each
Policy	Effective	Status of K51.90
Fecal Calprotectin TestingPayerPolicy · CIGNA-0121	Mar 15, 2026	Covered