K55.011 coverage policies: Medicare and commercial payers

46 active Medicare policies list K55.011, and 5 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 K55.011

LCD · FIRST_COAST-L36767

Aortography and peripheral angiography

J9 · Effective Oct 31, 2016

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 · NOVITAS-JH-L35092

Diagnostic Abdominal Aortography and Renal Angiography

JH · Effective Oct 1, 2015

LCD · NOVITAS-JL-L35092

Diagnostic Abdominal Aortography and Renal Angiography

JL · Effective Oct 1, 2015

LCD · FIRST_COAST-L33674

Duplex Scanning

J9 · Effective Oct 1, 2015

LCD · PALMETTO-JJ-L34424

Magnetic Resonance Angiography

Commercial payer policies listing K55.011

5 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 K55.011, with the code’s status in each
Policy	Effective	Status of K55.011
Gastrointestinal Function: Selected TestsPayerPolicy · AETNA-CPB-0396	Aug 30, 2023	Covered
Intestinal Rehabilitation ProgramsPayerPolicy · AETNA-CPB-0342	May 3, 2023	Covered
Transjugular Intrahepatic Portosystemic Shunt (TIPSS)PayerPolicy · AETNA-CPB-0259	May 5, 2023	Covered

Anthem

Anthem policies listing K55.011, with the code’s status in each
Policy	Effective	Status of K55.011
Gamma Glutamyl Transferase TestingClinical Guideline · ANTHEM-CG-LAB-29	Jul 1, 2026	Covered
Serum Iron TestingClinical Guideline · ANTHEM-CG-LAB-21