M25.519 coverage policies: Medicare and commercial payers

28 active Medicare policies list M25.519, 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 M25.519

LCD · NORIDIAN-JE-L39116

Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound

JE · Effective Nov 12, 2023

LCD · NORIDIAN-JF-L39116

Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound

JF · Effective Nov 12, 2023

LCD · PALMETTO-JJ-L39128

Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound

JJ · Effective Apr 30, 2023

LCD · PALMETTO-JM-L39128

Amniotic and Placental-Derived Product Injections and/or Applications for Musculoskeletal Indications, Non-Wound

JM · Effective Apr 30, 2023

LCD · PALMETTO-JJ-L37641

Continuous Peripheral Nerve Blocks (CPNB)

JJ · Effective Jan 29, 2018

LCD · PALMETTO-JM-L37641

Continuous Peripheral Nerve Blocks (CPNB)

JM · Effective Jan 29, 2018

LCD · FIRST_COAST-L33933

Peripheral Nerve Blocks

J9 · Effective Oct 1, 2015

LCD · NORIDIAN-JE-L34211

Trigger Point Injections (TPI)

JE · Effective Oct 1, 2015

LCD · NORIDIAN-JF-L34211

Trigger Point Injections (TPI)

Commercial payer policies listing M25.519

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 M25.519, with the code’s status in each
Policy	Effective	Status of M25.519
Prolotherapy and SclerotherapyPayerPolicy · AETNA-CPB-0207	Apr 11, 2023	Covered