R93.1 coverage policies: Medicare and commercial payers

75 active Medicare policies list R93.1, and 2 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 R93.1

LCD · FIRST_COAST-L36767

Aortography and peripheral angiography

J9 · Effective Oct 31, 2016

LCD · NORIDIAN-JE-L39881

Artificial Intelligence Enabled CT Based Quantitative Coronary Topography (AI-QCT )/Coronary Plaque Analysis (AI-CPA)

JE · Effective Dec 8, 2024

LCD · NORIDIAN-JF-L39881

Artificial Intelligence Enabled CT Based Quantitative Coronary Topography (AI-QCT )/Coronary Plaque Analysis (AI-CPA)

JF · Effective Dec 8, 2024

LCD · CGS-J15-L39840

Artificial Intelligence Enabled CT Based Quantitative Coronary Topography (AI-QCT)/Coronary Plaque Analysis (AI-CPA)

J15 · Effective Nov 24, 2024

LCD · NGS-J6-L39863

Artificial Intelligence Enabled CT Based Quantitative Coronary Topography (AI-QCT)/Coronary Plaque Analysis (AI-CPA)

J6 · Effective Nov 24, 2024

LCD · NGS-JK-L39863

Artificial Intelligence Enabled CT Based Quantitative Coronary Topography (AI-QCT)/Coronary Plaque Analysis (AI-CPA)

JK · Effective Nov 24, 2024

LCD · PALMETTO-JJ-L39851

Artificial Intelligence Enabled CT Based Quantitative Coronary Topography (AI-QCT)/Coronary Plaque Analysis (AI-CPA)

JJ · Effective Nov 24, 2024

LCD · PALMETTO-JM-L39851

Artificial Intelligence Enabled CT Based Quantitative Coronary Topography (AI-QCT)/Coronary Plaque Analysis (AI-CPA)

JM · Effective Nov 24, 2024

Commercial payer policies listing R93.1

2 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 R93.1, with the code’s status in each
Policy	Effective	Status of R93.1
Acoustic Heart Sound Recording and Computer AnalysisPayerPolicy · AETNA-CPB-0692	Sep 19, 2023	Covered

Cigna

Cigna policies listing R93.1, with the code’s status in each
Policy	Effective	Status of R93.1
Transthoracic Echocardiography in AdultsPayerPolicy · CIGNA-0510	Sep 15, 2026	Covered