Drugs and Biologicals, Coverage of, for Label and Off-Label Uses
J6 · Effective Oct 1, 2015
15 active Medicare policies list O09.93, and 6 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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J6 · Effective Oct 1, 2015
JK · Effective Oct 1, 2015
J15 · Effective Apr 17, 2022
JE · Effective Apr 17, 2022
JF · Effective Apr 17, 2022
JJ · Effective Apr 17, 2022
JM · Effective Apr 17, 2022
J5 · Effective Apr 17, 2022
6 policies from 1 payer
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of O09.93 |
|---|---|---|
| Maternity Ultrasound in the Outpatient Setting | Jan 6, 2026 | Covered |
| Outpatient Alpha-Fetoprotein Testing | Apr 15, 2026 | Covered |
| Outpatient Laboratory-based Blood Glucose Testing | Jul 1, 2026 | Covered |
| Outpatient Urine Culture | Jan 6, 2026 | Covered |
| Thyroid Testing | Apr 15, 2026 | Covered |
| Use of 3-D, 4-D or 5-D Ultrasound in Maternity Care | Apr 15, 2026 |
J8 · Effective Apr 17, 2022
National · Effective Aug 6, 2026
National · Effective Aug 6, 2026
National · Effective May 14, 2026
J5 · Effective Aug 6, 2026
J6 · Effective Apr 1, 2026
National · Effective Nov 6, 2025
| Not covered |