S06.89AD coverage policies: Medicare and commercial payers

27 active Medicare policies list S06.89AD, 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 S06.89AD

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 · PALMETTO-JJ-L39400

Magnesium

JJ · Effective Jan 22, 2023

LCD · PALMETTO-JM-L39400

Magnesium

JM · Effective Jan 22, 2023

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 · NGS-J6-L33632

Psychiatry and Psychology Services

J6 · Effective Oct 1, 2015

LCD · NGS-JK-L33632

Psychiatry and Psychology Services

JK · Effective Oct 1, 2015

LCD · NGS-J6-L34380

Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)

J6 · Effective Oct 1, 2015

LCD · NGS-JK-L34380

Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)

JK · Effective Oct 1, 2015

Commercial payer policies listing S06.89AD

1 policy from 1 payer

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

Ambetter

Ambetter policies listing S06.89AD, with the code’s status in each
Policy	Effective	Status of S06.89AD
Medically Necessary Optical HardwarePayerPolicy · AMBETTER-CP-VP-06	Not recorded	Covered