K63.5 coverage policies: Medicare and commercial payers

58 active Medicare policies list K63.5, and 3 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 K63.5

LCD · WPS-J5-L35490

Category III Codes

J5 · Effective Oct 1, 2015

LCD · WPS-J8-L35490

Category III Codes

J8 · Effective Oct 1, 2015

LCD · CGS-J15-L38777

Colon Capsule Endoscopy (CCE)

J15 · Effective Mar 29, 2021

LCD · FIRST_COAST-L38805

Colon Capsule Endoscopy (CCE)

J9 · Effective Mar 28, 2021

LCD · NGS-J6-L38571

Colon Capsule Endoscopy (CCE)

J6 · Effective Apr 15, 2021

LCD · NGS-J6-L39122

Colon Capsule Endoscopy (CCE)

LCD · NGS-JK-L38571

Colon Capsule Endoscopy (CCE)

JK · Effective Apr 15, 2021

LCD · NGS-JK-L39122

Colon Capsule Endoscopy (CCE)

LCD · NORIDIAN-JE-L38824

Colon Capsule Endoscopy (CCE)

JE · Effective Mar 28, 2021

LCD · NORIDIAN-JF-L38824

Colon Capsule Endoscopy (CCE)

JF · Effective Mar 28, 2021

LCD · NOVITAS-JH-L38807

Commercial payer policies listing K63.5

3 policies from 3 payers

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

Aetna

Aetna policies listing K63.5, with the code’s status in each
Policy	Effective	Status of K63.5
In Vivo Analysis of Gastro-Intestinal and Urothelial LesionsPayerPolicy · AETNA-CPB-0783	Oct 17, 2023	Covered

Ambetter

Ambetter policies listing K63.5, with the code’s status in each
Policy	Effective	Status of K63.5
Concert Genetic Testing: Hereditary CancerPayerPolicy · AMBETTER-CONCERT-GENETIC-TESTING-HEREDITARY-CANCER	Not recorded	Referenced

Anthem

Anthem policies listing K63.5, with the code’s status in each
Policy	Effective	Status of K63.5
Serum Iron TestingClinical Guideline · ANTHEM-CG-LAB-21	Apr 15, 2026	Covered