T86.09 coverage policies: Medicare and commercial payers

30 active Medicare policies list T86.09, and 3 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 T86.09

Free account. Policy pages stay open to everyone.

Medicare policies listing T86.09

LCD · NOVITAS-JH-L34914

Assays for Vitamins and Metabolic Function

JH · Effective Oct 1, 2015

LCD · NOVITAS-JL-L34914

Assays for Vitamins and Metabolic Function

JL · Effective Oct 1, 2015

LCD · WPS-J5-L37205

Chemotherapy Drugs and their Adjuncts

J5 · Effective Sep 16, 2017

LCD · WPS-J8-L37205

Chemotherapy Drugs and their Adjuncts

J8 · Effective Sep 16, 2017

LCD · NGS-J6-L33394

Drugs and Biologicals, Coverage of, for Label and Off-Label Uses

J6 · Effective Oct 1, 2015

LCD · NGS-JK-L33394

Drugs and Biologicals, Coverage of, for Label and Off-Label Uses

JK · Effective Oct 1, 2015

LCD · CGS-J15-L34037

Flow Cytometry

J15 · Effective Oct 1, 2015

LCD · NORIDIAN-JE-L34314

Immune Globulin Intravenous (IVIg)

JE · Effective Oct 1, 2015

LCD · NORIDIAN-JF-L34314

Immune Globulin Intravenous (IVIg)

JF · Effective Oct 1, 2015

LCD · CGS-J15-L35891

Intravenous Immune Globulin

Commercial payer policies listing T86.09

3 policies from 2 payers

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

Anthem

Anthem policies listing T86.09, with the code’s status in each
Policy	Effective	Status of T86.09
Serum Iron TestingClinical Guideline · ANTHEM-CG-LAB-21	Apr 15, 2026	Covered
Therapeutic ApheresisClinical Guideline · ANTHEM-CG-MED-68	Apr 15, 2026	Covered

Aetna

Aetna policies listing T86.09, with the code’s status in each
Policy	Effective	Status of T86.09
Extracorporeal Photochemotherapy (Photopheresis)PayerPolicy · AETNA-CPB-0241	Mar 29, 2023	Covered