R05.3 coverage policies: Medicare and commercial payers

47 active Medicare policies list R05.3, 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 R05.3

LCD · NORIDIAN-JE-L40324

Allergy Diagnostic Testing

JE · Effective Sep 27, 2026

LCD · NORIDIAN-JF-L40324

Allergy Diagnostic Testing

JF · Effective Sep 27, 2026

LCD · PALMETTO-JJ-L40328

Allergy Diagnostic Testing

JJ · Effective Sep 27, 2026

LCD · PALMETTO-JM-L40328

Allergy Diagnostic Testing

JM · Effective Sep 27, 2026

LCD · FIRST_COAST-L33261

Allergy Testing

J9 · Effective Oct 1, 2015

LCD · NORIDIAN-L34313

Allergy Testing

JE · Effective Oct 1, 2015

LCD · NOVITAS-JH-L36241

Allergy Testing

JH · Effective Oct 1, 2015

LCD · NOVITAS-JL-L36241

Allergy Testing

JL · Effective Oct 1, 2015

LCD · WPS-J5-L36402

Allergy Testing

J5 · Effective Mar 18, 2016

LCD · WPS-J8-L36402

Allergy Testing

J8 · Effective Mar 18, 2016

LCD · PALMETTO-JJ-L33459

Commercial payer policies listing R05.3

3 policies from 2 payers

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

Ambetter

Ambetter policies listing R05.3, with the code’s status in each
Policy	Effective	Status of R05.3
Polymerase Chain Reaction Respiratory Viral Panel TestingPayerPolicy · AMBETTER-CP-MP-181	Not recorded	Covered
Pulmonary Function TestingPayerPolicy · AMBETTER-CP-MP-242	Not recorded	Covered

Aetna

Aetna policies listing R05.3, with the code’s status in each
Policy	Effective	Status of R05.3
Esophageal and Airway pH MonitoringPayerPolicy · AETNA-CPB-0667	Sep 25, 2023	Covered