K74.5 coverage policies: Medicare and commercial payers

32 active Medicare policies list K74.5, and 1 commercial payer policy lists 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 K74.5

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 · 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-L33583

Diagnostic and Therapeutic Esophagogastroduodenoscopy

J9 · Effective Oct 1, 2015

LCD · NOVITAS-JH-L35049

Monitored Anesthesia Care

JH · Effective Oct 1, 2015

LCD · NOVITAS-JL-L35049

Monitored Anesthesia Care

JL · Effective Oct 1, 2015

LCD · WPS-J5-L35755

Non-Invasive Abdominal / Visceral Vascular Studies

J5 · Effective Oct 1, 2015

LCD · WPS-J8-L35755

Non-Invasive Abdominal / Visceral Vascular Studies

J8 · Effective Oct 1, 2015

LCD · NOVITAS-JH-L35350

Upper Gastrointestinal Endoscopy (Diagnostic and Therapeutic)

Commercial payer policies listing K74.5

1 policy from 1 payer

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

Aetna

Aetna policies listing K74.5, with the code’s status in each
Policy	Effective	Status of K74.5
Magnetic Resonance CholangiopancreatographyPayerPolicy · AETNA-CPB-0384	Feb 15, 2024	Covered