K55.1 coverage policies: Medicare and commercial payers

58 active Medicare policies list K55.1, 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 K55.1

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-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 · NOVITAS-JH-L35092

Diagnostic Abdominal Aortography and Renal Angiography

JH · Effective Oct 1, 2015

LCD · NOVITAS-JL-L35092

Diagnostic Abdominal Aortography and Renal Angiography

Commercial payer policies listing K55.1

2 policies from 1 payer

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

Aetna

Aetna policies listing K55.1, with the code’s status in each
Policy	Effective	Status of K55.1
Intestinal Rehabilitation ProgramsPayerPolicy · AETNA-CPB-0342	May 3, 2023	Covered
Transjugular Intrahepatic Portosystemic Shunt (TIPSS)PayerPolicy · AETNA-CPB-0259	May 5, 2023	Covered