H20.013 coverage policies: Medicare and commercial payers

29 active Medicare policies list H20.013, 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.

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Medicare policies listing H20.013

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 · 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 · CGS-J15-L34393

Ocular Photography - External

J15 · Effective Oct 1, 2015

LCD · NGS-J6-L39314

Off-Label Use of Intravenous Immune Globulin (IVIG)

J6 · Effective Nov 1, 2022

LCD · NGS-JK-L39314

Off-Label Use of Intravenous Immune Globulin (IVIG)

JK · Effective Nov 1, 2022

LCD · PALMETTO-JJ-L33467

Ophthalmology: Extended Ophthalmoscopy and Fundus Photography

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L33467

Ophthalmology: Extended Ophthalmoscopy and Fundus Photography

Commercial payer policies listing H20.013

4 policies from 1 payer

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

Ambetter

Ambetter policies listing H20.013, with the code’s status in each
Policy	Effective	Status of H20.013
Extended OphthalmoscopyPayerPolicy · AMBETTER-CP-VP-26	Not recorded	Covered
External Ocular PhotographyPayerPolicy · AMBETTER-CP-VP-43	Not recorded	Covered
GonioscopyPayerPolicy · AMBETTER-CP-VP-31	Not recorded	Covered
Visual Field TestingPayerPolicy · AMBETTER-CP-VP-63	Not recorded	Covered