T85.79XD coverage policies: Medicare and commercial payers

31 active Medicare policies list T85.79XD, 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 T85.79XD

LCD · NGS-J6-L33585

Breast Imaging: Breast Echography (Sonography)/Breast MRI/Ductography

J6 · Effective Oct 1, 2015

LCD · NGS-JK-L33585

Breast Imaging: Breast Echography (Sonography)/Breast MRI/Ductography

JK · Effective Oct 1, 2015

LCD · CGS-J15-L39506

Cosmetic and Reconstructive Surgery

J15 · Effective May 28, 2023

LCD · PALMETTO-JJ-L33428

Cosmetic and Reconstructive Surgery

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L33428

Cosmetic and Reconstructive Surgery

JM · Effective Oct 1, 2015

LCD · WPS-J5-L39051

Cosmetic and Reconstructive Surgery

J5 · Effective Nov 14, 2021

LCD · WPS-J8-L39051

Cosmetic and Reconstructive Surgery

J8 · Effective Nov 14, 2021

LCD · NORIDIAN-JE-L34220

Lumbar MRI

JE · Effective Oct 1, 2015

LCD · NORIDIAN-JF-L34220

Lumbar MRI

JF · Effective Oct 1, 2015

LCD · NORIDIAN-JE-L37373

MRI and CT Scans of the Head and Neck

JE · Effective Oct 8, 2018

Commercial payer policies listing T85.79XD

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 T85.79XD, with the code’s status in each
Policy	Effective	Status of T85.79XD
Medically Necessary Optical HardwarePayerPolicy · AMBETTER-CP-VP-06	Not recorded	Covered