E09.311 coverage policies: Medicare and commercial payers

82 active Medicare policies list E09.311, and 7 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 E09.311

LCD · CGS-J15-L33954

Cataract Extraction

J15 · Effective Oct 1, 2015

LCD · WPS-J5-L35490

Category III Codes

J5 · Effective Oct 1, 2015

LCD · WPS-J8-L35490

Category III Codes

J8 · Effective Oct 1, 2015

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-L38992

Electroretinography (ERG)

J15 · Effective Jan 30, 2022

LCD · FIRST_COAST-L37398

Electroretinography (ERG)

J9 · Effective Feb 2, 2018

LCD · NOVITAS-JH-L37371

Electroretinography (ERG)

JH · Effective Jan 25, 2018

LCD · NOVITAS-JL-L37371

Electroretinography (ERG)

JL · Effective Jan 25, 2018

LCD · PALMETTO-JJ-L33431

HbA1c

JJ · Effective Oct 1, 2015

Commercial payer policies listing E09.311

7 policies from 3 payers

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

Aetna

Aetna policies listing E09.311, with the code’s status in each
Policy	Effective	Status of E09.311
ADAMTS13 Assay for Thrombotic Thrombocytopenic Purpura (TTP)PayerPolicy · AETNA-CPB-0780	Oct 26, 2023	Covered
Artificial Retina and Artificial IrisPayerPolicy · AETNA-CPB-0713	Oct 17, 2023	Covered
Fluocinolone Acetonide Intra-vitreal Implant (Retisert, Yutiq and Iluvien)PayerPolicy · AETNA-CPB-0719	Jan 5, 2024	Covered
Optic Nerve and Retinal Imaging MethodsPayerPolicy · AETNA-CPB-0344	May 17, 2023	Covered
Retinopathy Telescreening SystemsPayerPolicy · AETNA-CPB-0563	Aug 10, 2023	Covered

Anthem