S13.4XXA coverage policies: Medicare and commercial

S13.4XXA coverage policies: Medicare and commercial payers

19 active Medicare policies list S13.4XXA, 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.

Get free alerts for S13.4XXA

Free account. Policy pages stay open to everyone.

Medicare policies listing S13.4XXA

LCD · NORIDIAN-JE-L34218

Injections - Tendon, Ligament, Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma

JE · Effective Oct 1, 2015

LCD · NORIDIAN-JF-L34218

Injections - Tendon, Ligament, Ganglion Cyst, Tunnel Syndromes and Morton's Neuroma

JF · 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 · NORIDIAN-JE-L34211

Trigger Point Injections (TPI)

JE · Effective Oct 1, 2015

LCD · NORIDIAN-JF-L34211

Trigger Point Injections (TPI)

JF · Effective Oct 1, 2015

LCD · PALMETTO-JJ-L39671

Trigger Point Injections (TPI)

JJ · Effective Mar 31, 2024

LCD · PALMETTO-JM-L39671

Trigger Point Injections (TPI)

JM · Effective Mar 31, 2024

Article · A56273

Billing and Coding: Chiropractic Services

National · Effective Aug 28, 2025

Article · A53058

Commercial payer policies listing S13.4XXA

2 policies from 1 payer

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

Cigna

Cigna policies listing S13.4XXA, with the code’s status in each
Policy	Effective	Status of S13.4XXA
AcupuncturePayerPolicy · CIGNA-CPG024	Apr 15, 2026	Covered
Intraoperative MonitoringPayerPolicy · CIGNA-0509	Sep 15, 2025	Covered