T86.19 coverage policies: Medicare and commercial payers

83 active Medicare policies list T86.19, and 6 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 T86.19

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 · FIRST_COAST-L38396

Cardiology Non-emergent Outpatient Stress Testing

J9 · Effective Mar 15, 2020

LCD · NOVITAS-JH-L35083

Cardiology Non-emergent Outpatient Stress Testing

JH · Effective Oct 1, 2015

LCD · NOVITAS-JL-L35083

Cardiology Non-emergent Outpatient Stress Testing

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 · PALMETTO-JJ-L34415

CT of the Abdomen and Pelvis

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L34415

CT of the Abdomen and Pelvis

JM · Effective Oct 1, 2015

LCD · NGS-J6-L33394

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

Commercial payer policies listing T86.19

6 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 T86.19, with the code’s status in each
Policy	Effective	Status of T86.19
Extracorporeal Photochemotherapy (Photopheresis)PayerPolicy · AETNA-CPB-0241	Mar 29, 2023	Covered
Heart-Lung TransplantationPayerPolicy · AETNA-CPB-0597	Sep 7, 2023	Covered
Polymerase Chain Reaction Testing: Selected IndicationsPayerPolicy · AETNA-CPB-0650	Feb 9, 2024	Covered
Radiofrequency Tumor AblationPayerPolicy · AETNA-CPB-0492	Oct 6, 2023	Covered

Anthem

Anthem policies listing T86.19, with the code’s status in each
Policy	Effective	Status of T86.19
Pancreas Transplantation and Pancreas Kidney TransplantationPayerPolicy · ANTHEM-TRANS.00011