S12.000A coverage policies: Medicare and commercial payers

46 active Medicare policies list S12.000A, and 5 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 S12.000A

LCD · CGS-J15-L36460

Bone Mass Measurement

J15 · Effective Feb 1, 2016

LCD · PALMETTO-JJ-L39268

Bone Mass Measurement

JJ · Effective Sep 18, 2022

LCD · PALMETTO-JM-L39268

Bone Mass Measurement

JM · Effective Sep 18, 2022

LCD · CGS-J15-L39741

Cervical Fusion

J15 · Effective Jul 7, 2024

LCD · FIRST_COAST-L39799

Cervical Fusion

J9 · Effective Aug 11, 2024

LCD · NGS-J6-L39770

Cervical Fusion

J6 · Effective Aug 1, 2024

LCD · NGS-JK-L39770

Cervical Fusion

JK · Effective Aug 1, 2024

LCD · NORIDIAN-JE-L39758

Cervical Fusion

JE · Effective Jul 7, 2024

LCD · NORIDIAN-JF-L39758

Cervical Fusion

JF · Effective Jul 7, 2024

LCD · NOVITAS-JH-L39793

Cervical Fusion

JH · Effective Aug 11, 2024

LCD · NOVITAS-JL-L39793

Commercial payer policies listing S12.000A

5 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 S12.000A, with the code’s status in each
Policy	Effective	Status of S12.000A
Back Pain - Invasive ProceduresPayerPolicy · AETNA-CPB-0016	Mar 13, 2024	Covered
DefecographyPayerPolicy · AETNA-CPB-0718	Sep 21, 2023	Covered
Pulsed Electromagnetic StimulationPayerPolicy · AETNA-CPB-0175	Mar 14, 2023	Covered
ThermographyPayerPolicy · AETNA-CPB-0029	Mar 15, 2023	Covered

Anthem

Anthem policies listing S12.000A, with the code’s status in each
Policy	Effective	Status of S12.000A
Manipulation Under AnesthesiaClinical Guideline · ANTHEM-CG-MED-65	Oct 1, 2026