R94.30 coverage policies: Medicare and commercial payers

27 active Medicare policies list R94.30, and 1 commercial payer policy lists 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 R94.30

LCD · WPS-J5-L39913

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

J5 · Effective Nov 24, 2024

LCD · WPS-J8-L39913

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

J8 · Effective Nov 24, 2024

LCD · PALMETTO-JJ-L33457

Cardiac Radionuclide Imaging

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L33457

Cardiac Radionuclide Imaging

JM · Effective Oct 1, 2015

LCD · CGS-J15-L33947

Cardiac Computed Tomography (CCT) and Coronary Computed Tomography Angiography (CCTA)

J15 · Effective Oct 1, 2015

LCD · PALMETTO-JJ-L33423

Cardiac Computed Tomography & Angiography (CCTA)

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L33423

Cardiac Computed Tomography & Angiography (CCTA)

JM · Effective Oct 1, 2015

LCD · NORIDIAN-JE-L34324

Cardiovascular Stress Testing, Including Exercise and/or Pharmacological Stress and Stress Echocardiography

JE · Effective Oct 1, 2015

LCD · NORIDIAN-JF-L34324

Cardiovascular Stress Testing, Including Exercise and/or Pharmacological Stress and Stress Echocardiography

Commercial payer policies listing R94.30

1 policy from 1 payer

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

Aetna

Aetna policies listing R94.30, with the code’s status in each
Policy	Effective	Status of R94.30
Acoustic Heart Sound Recording and Computer AnalysisPayerPolicy · AETNA-CPB-0692	Sep 19, 2023	Covered