Z85.46 coverage policies: Medicare and commercial payers

68 active Medicare policies list Z85.46, and 4 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 Z85.46

Free account. Policy pages stay open to everyone.

Medicare policies listing Z85.46

LCD · WPS-J5-L34648

Bisphosphonate Drug Therapy

J5 · Effective Oct 1, 2015

LCD · WPS-J8-L34648

Bisphosphonate Drug Therapy

J8 · Effective Oct 1, 2015

LCD · FIRST_COAST-L36499

BRCA1 and BRCA2 Genetic Testing

J9 · Effective Apr 11, 2016

LCD · NOVITAS-JH-L36715

BRCA1 and BRCA2 Genetic Testing

JH · Effective Dec 1, 2016

LCD · NOVITAS-JL-L36715

BRCA1 and BRCA2 Genetic Testing

JL · Effective Dec 1, 2016

LCD · PALMETTO-JJ-L33457

Cardiac Radionuclide Imaging

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L33457

Cardiac Radionuclide Imaging

JM · Effective Oct 1, 2015

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

J6 · Effective Oct 1, 2015

Commercial payer policies listing Z85.46

4 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 Z85.46, with the code’s status in each
Policy	Effective	Status of Z85.46
Positron Emission Tomography (PET)PayerPolicy · AETNA-CPB-0071	Sep 21, 2023	Covered
Prostate Cancer ScreeningPayerPolicy · AETNA-CPB-0521	Jul 14, 2023	Covered

Anthem

Anthem policies listing Z85.46, with the code’s status in each
Policy	Effective	Status of Z85.46
Prostate Specific Antigen TestingClinical Guideline · ANTHEM-CG-LAB-28	Apr 15, 2026	Covered
Transrectal UltrasonographyClinical Guideline · ANTHEM-CG-RAD-28	Apr 15, 2026	Covered