Biomarkers for Oncology
JH · Effective Oct 1, 2015
27 active Medicare policies list N40.3, and 8 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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JH · Effective Oct 1, 2015
JL · Effective Oct 1, 2015
JJ · Effective Oct 1, 2015
JM · Effective Oct 1, 2015
J15 · Effective Oct 1, 2015
J15 · Effective Jul 17, 2022
JE · Effective Aug 8, 2022
JF · Effective Aug 8, 2022
JJ · Effective Jul 3, 2022
8 policies from 3 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of N40.3 |
|---|---|---|
| Benign Prostatic Hyperplasia | Feb 8, 2024 | Covered |
| Botulinum Toxin | Jan 1, 2024 | Covered |
| Cryoablation | Dec 5, 2023 | Covered |
| Intraoperative Neurophysiological Monitoring | Oct 26, 2023 | Covered |
| Prostate Cancer Screening | Jul 14, 2023 | Covered |
| Policy |
|---|
JM · Effective Jul 3, 2022
J5 · Effective Jul 3, 2022
J8 · Effective Jul 3, 2022
J6 · Effective Oct 1, 2015
JK · Effective Oct 1, 2015
J15 · Effective Oct 1, 2015
J6 · Effective Oct 1, 2015
JK · Effective Oct 1, 2015
JL · Effective Apr 24, 2025
National · Effective Oct 1, 2026
National · Effective Apr 2, 2026
National · Effective Jun 25, 2026
National · Effective Jun 25, 2026
National · Effective Jun 25, 2026
J5 · Effective Jun 25, 2026
J6 · Effective Apr 1, 2026
National · Effective Oct 2, 2025
J6 · Effective Apr 1, 2026
| Effective |
|---|
| Status of N40.3 |
|---|
| Prostate Specific Antigen Testing | Apr 15, 2026 | Covered |
|---|---|---|
| Transrectal Ultrasonography | Apr 15, 2026 | Covered |
| Policy | Effective | Status of N40.3 |
|---|---|---|
| Urodynamic Testing (CP.MP.98) | Not recorded | Covered |