Z94.5 coverage policies: Medicare and commercial payers

26 active Medicare policies list Z94.5, 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.

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Medicare policies listing Z94.5

LCD · CGS-J15-L34037

Flow Cytometry

J15 · Effective Oct 1, 2015

LCD · FIRST_COAST-L38227

Gastrointestinal Pathogen (GIP) Panels Utilizing Multiplex Nucleic Acid Amplification Techniques (NAATs)

J9 · Effective Dec 30, 2019

LCD · NOVITAS-JH-L38229

Gastrointestinal Pathogen (GIP) Panels Utilizing Multiplex Nucleic Acid Amplification Techniques (NAATs)

JH · Effective Dec 30, 2019

LCD · NOVITAS-JL-L38229

Gastrointestinal Pathogen (GIP) Panels Utilizing Multiplex Nucleic Acid Amplification Techniques (NAATs)

JL · Effective Dec 30, 2019

LCD · NORIDIAN-JE-L34215

Lab: Flow Cytometry

JE · Effective Oct 1, 2015

LCD · NORIDIAN-JF-L34215

Lab: Flow Cytometry

JF · Effective Oct 1, 2015

LCD · PALMETTO-JJ-L34513

Lab: Flow Cytometry

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L34513

Lab: Flow Cytometry

JM · Effective Oct 1, 2015

LCD · CGS-J15-L39038

MolDX: Molecular Syndromic Panels for Infectious Disease Pathogen Identification Testing

J15 · Effective Apr 17, 2022

Commercial payer policies listing Z94.5

2 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 Z94.5, with the code’s status in each
Policy	Effective	Status of Z94.5
Pulsed Electromagnetic StimulationPayerPolicy · AETNA-CPB-0175	Mar 14, 2023	Covered

Ambetter

Ambetter policies listing Z94.5, with the code’s status in each
Policy	Effective	Status of Z94.5
Polymerase Chain Reaction Respiratory Viral Panel TestingPayerPolicy · AMBETTER-CP-MP-181	Not recorded	Covered