M54.17 coverage policies: Medicare and commercial payers

111 active Medicare policies list M54.17, and 3 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 M54.17

Showing 100 of 111

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 M54.17

3 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 M54.17, with the code’s status in each
Policy	Effective	Status of M54.17
Back Pain - Invasive ProceduresPayerPolicy · AETNA-CPB-0016	Mar 13, 2024	Covered
DiscographyPayerPolicy · AETNA-CPB-0733	Oct 6, 2023	Covered
Pulsed RadiofrequencyPayerPolicy · AETNA-CPB-0735	Sep 20, 2023	Covered