M54.16 coverage policies: Medicare and commercial payers

115 active Medicare policies list M54.16, 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 M54.16

Showing 100 of 115

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-L39799

Cervical Fusion

J9 · Effective Aug 11, 2024

LCD · NOVITAS-JH-L39793

Cervical Fusion

JH · Effective Aug 11, 2024

LCD · NOVITAS-JL-L39793

Cervical Fusion

JL · Effective Aug 11, 2024

LCD · PALMETTO-JJ-L37641

Continuous Peripheral Nerve Blocks (CPNB)

JJ · Effective Jan 29, 2018

LCD · PALMETTO-JM-L37641

Continuous Peripheral Nerve Blocks (CPNB)

Commercial payer policies listing M54.16

2 policies from 1 payer

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

Aetna

Aetna policies listing M54.16, with the code’s status in each
Policy	Effective	Status of M54.16
Blood and Adipose Tissue Derived Products for Selected IndicationsPayerPolicy · AETNA-CPB-0784	Oct 26, 2023	Covered
DiscographyPayerPolicy · AETNA-CPB-0733	Oct 6, 2023	Covered