Medica policy
Replacement Codes
Replacement Codes is a public Medica policy (policy RP-P-580X, effective Nov 1, 2025). It lists 5 CPT or HCPCS codes. Not a coverage decision; the payer's own document governs.
View the original policy (PDF) ↗
- Payer
- Medica
- Policy number
- RP-P-580X
- Effective
- Nov 1, 2025
- Line of business
- Commercial
- Source
- partner.medica.com
Codes in this policy
The CPT and HCPCS codes the policy names. A policy can name a code it excludes.
| Code | Other Medica policies |
|---|---|
| 77387 | Policies naming 77387 |
| 77402 | Policies naming 77402 |
| G6001 | Policies naming G6001 |
| G6002 | Policies naming G6002 |
| G6003 | Policies naming G6003 |