M79.89 coverage policies: Medicare and commercial payers

31 active Medicare policies list M79.89, 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 M79.89

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 · CGS-J15-L34062

Dialysis Access Maintenance

J15 · Effective Oct 1, 2015

LCD · PALMETTO-JJ-L35048

Nerve Conduction Studies and Electromyography

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L35048

Nerve Conduction Studies and Electromyography

JM · Effective Oct 1, 2015

LCD · WPS-J5-L35751

Non-Invasive Peripheral Venous Vascular and Hemodialysis Access Studies

J5 · Effective Oct 1, 2015

LCD · WPS-J8-L35751

Non-Invasive Peripheral Venous Vascular and Hemodialysis Access Studies

Commercial payer policies listing M79.89

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 M79.89, with the code’s status in each
Policy	Effective	Status of M79.89
Cryoanalgesia and Therapeutic ColdPayerPolicy · AETNA-CPB-0297	Mar 16, 2023	Covered