R43.0 coverage policies: Medicare and commercial payers

23 active Medicare policies list R43.0, and 4 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 R43.0

LCD · NORIDIAN-L34313

Allergy Testing

JE · 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-L34417

CT of the Head

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L34417

CT of the Head

JM · Effective Oct 1, 2015

LCD · NORIDIAN-JE-L37373

MRI and CT Scans of the Head and Neck

JE · Effective Oct 8, 2018

LCD · NORIDIAN-JF-L37373

MRI and CT Scans of the Head and Neck

JF · Effective Oct 8, 2018

LCD · FIRST_COAST-L34859

Nerve Conduction Studies and Electromyography

J9 · Effective Oct 1, 2015

LCD · NOVITAS-JH-L35081

Nerve Conduction Studies and Electromyography

JH · Effective Oct 1, 2015

LCD · NOVITAS-JL-L35081

Nerve Conduction Studies and Electromyography

JL · Effective Oct 1, 2015

Commercial payer policies listing R43.0

4 policies from 1 payer

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

Aetna

Aetna policies listing R43.0, with the code’s status in each
Policy	Effective	Status of R43.0
Alzheimer's Disease TestsPayerPolicy · AETNA-CPB-0349	Sep 8, 2023	Covered
Evaluation of SinusitisPayerPolicy · AETNA-CPB-0694	Sep 26, 2023	Covered
Positron Emission Tomography (PET)PayerPolicy · AETNA-CPB-0071	Sep 21, 2023	Covered
Smell and Taste Disorders: DiagnosisPayerPolicy · AETNA-CPB-0390	Jun 22, 2023	Covered