R26.0 coverage policies: Medicare and commercial payers

68 active Medicare policies list R26.0, 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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Medicare policies listing R26.0

LCD · NOVITAS-JH-L34914

Assays for Vitamins and Metabolic Function

JH · Effective Oct 1, 2015

LCD · NOVITAS-JL-L34914

Assays for Vitamins and Metabolic Function

JL · Effective Oct 1, 2015

LCD · CGS-J15-L38694

Computed Tomography Cerebral Perfusion Analysis (CTP)

J15 · Effective Nov 2, 2020

LCD · NGS-J6-L38667

Computed Tomography Cerebral Perfusion Analysis (CTP)

J6 · Effective Nov 1, 2020

LCD · NGS-JK-L38667

Computed Tomography Cerebral Perfusion Analysis (CTP)

JK · Effective Nov 1, 2020

LCD · NORIDIAN-JE-L38709

Computed Tomography Cerebral Perfusion Analysis (CTP)

JE · Effective Dec 13, 2020

LCD · NORIDIAN-JF-L38709

Computed Tomography Cerebral Perfusion Analysis (CTP)

JF · Effective Dec 13, 2020

LCD · PALMETTO-JJ-L38769

Computed Tomography Cerebral Perfusion Analysis (CTP)

JJ · Effective Feb 7, 2021

LCD · PALMETTO-JM-L38769

Computed Tomography Cerebral Perfusion Analysis (CTP)

JM · Effective Feb 7, 2021

LCD · PALMETTO-JJ-L34417

Commercial payer policies listing R26.0

6 policies from 2 payers

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

Aetna

Aetna policies listing R26.0, with the code’s status in each
Policy	Effective	Status of R26.0
Chronic VertigoPayerPolicy · AETNA-CPB-0238	Apr 26, 2023	Covered
Endolymphatic Hydrops (Meniere's Disease) TestsPayerPolicy · AETNA-CPB-0571	Aug 11, 2023	Covered
Gait Analysis and ElectrodynogramPayerPolicy · AETNA-CPB-0263	May 4, 2023	Covered
Genetic TestingPayerPolicy · AETNA-CPB-0140	Feb 27, 2024	Covered

Anthem

Anthem policies listing R26.0, with the code’s status in each
Policy	Effective	Status of R26.0
Functional Electrical Stimulation (FES); Threshold Electrical Stimulation (TES)PayerPolicy · ANTHEM-DME.00022