M33.92 coverage policies: Medicare and commercial payers

63 active Medicare policies list M33.92, 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 M33.92

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 · 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 · NORIDIAN-JE-L34314

Immune Globulin Intravenous (IVIg)

JE · Effective Oct 1, 2015

LCD · NORIDIAN-JF-L34314

Immune Globulin Intravenous (IVIg)

JF · Effective Oct 1, 2015

LCD · WPS-J5-L34771

Immune Globulins

Commercial payer policies listing M33.92

1 policy from 1 payer

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

UnitedHealthcare

UnitedHealthcare policies listing M33.92, with the code’s status in each
Policy	Effective	Status of M33.92
Airway Clearance DevicesPayerPolicy · UHC-POL-airway-clearance-devices	Mar 1, 2026	Covered