2 commercial payer policies list H04.339. 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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2 policies from 1 payer
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of H04.339 |
|---|---|---|
| Fluocinolone Acetonide Intra-vitreal Implant (Retisert, Yutiq and Iluvien) | Jan 5, 2024 | Covered |
| Nasolacrimal Duct Obstruction: Treatments | Jun 8, 2023 | Covered |