Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound
JE · Effective Nov 12, 2023
11 active Medicare policies list M04.1, and 9 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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JE · Effective Nov 12, 2023
JF · Effective Nov 12, 2023
JJ · Effective Apr 30, 2023
JM · Effective Apr 30, 2023
National · Effective Oct 1, 2026
National · Effective Oct 1, 2026
J6 · Effective Oct 1, 2026
9 policies from 4 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of M04.1 |
|---|---|---|
| Gamma Glutamyl Transferase Testing | Jul 1, 2026 | Covered |
| Outpatient Laboratory-based Blood Glucose Testing | Jul 1, 2026 | Covered |
| Outpatient Urine Culture | Jan 6, 2026 | Covered |
| Therapeutic use of Stem Cells, Blood and Bone Marrow Products | Oct 1, 2026 | Not covered |
| Thyroid Testing | Apr 15, 2026 | Covered |
National · Effective Oct 1, 2025
J5 · Effective Oct 1, 2026
J9 · Effective Jan 1, 2026
JL · Effective Jan 1, 2026
| Policy | Effective | Status of M04.1 |
|---|
| Autonomic Testing / Sudomotor Tests | Jul 13, 2023 | Covered |
|---|---|---|
| Heart Transplantation | Aug 30, 2023 | Covered |
| Policy | Effective | Status of M04.1 |
|---|---|---|
| Concert Genetic Testing: Immunology and Rheumatology | Not recorded | Referenced |
| Policy | Effective | Status of M04.1 |
|---|---|---|
| Ilaris (Canakinumab) | Nov 1, 2025 | Covered |