M47.817 coverage policies: Medicare and commercial

M47.817 coverage policies: Medicare and commercial payers

102 active Medicare policies list M47.817, and 2 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 M47.817

Showing 100 of 102

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 · FIRST_COAST-L36393

Controlled Substance Monitoring and Drugs of Abuse Testing

J9 · Effective Oct 11, 2015

LCD · NOVITAS-JH-L35006

Controlled Substance Monitoring and Drugs of Abuse Testing

JH · Effective Oct 1, 2015

LCD · NOVITAS-JL-L35006

Controlled Substance Monitoring and Drugs of Abuse Testing

JL · Effective Oct 1, 2015

LCD · CGS-J15-L38773

Facet Joint Interventions for Pain Management

J15 · Effective May 2, 2021

LCD · FIRST_COAST-L33930

Commercial payer policies listing M47.817

2 policies from 2 payers

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

Aetna

Aetna policies listing M47.817, with the code’s status in each
Policy	Effective	Status of M47.817
DiscographyPayerPolicy · AETNA-CPB-0733	Oct 6, 2023	Covered

UnitedHealthcare

UnitedHealthcare policies listing M47.817, with the code’s status in each
Policy	Effective	Status of M47.817
Facet Joint and Medial Branch Block Injections for Spinal PainPayerPolicy · UHC-POL-facet-joint-injections-spinal-pain	Sep 10, 2026	Covered