Drugs and Biologicals, Coverage of, for Label and Off-Label Uses
J6 · Effective Oct 1, 2015
21 active Medicare policies list H20.821, and 8 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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J6 · Effective Oct 1, 2015
JK · Effective Oct 1, 2015
J15 · Effective Oct 1, 2015
J6 · Effective Nov 1, 2022
JK · Effective Nov 1, 2022
JJ · Effective Oct 1, 2015
JM · Effective Oct 1, 2015
J15 · Effective Oct 1, 2015
J6 · Effective Oct 1, 2015
8 policies from 3 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of H20.821 |
|---|---|---|
| Extended Ophthalmoscopy | Not recorded | Covered |
| External Ocular Photography | Not recorded | Covered |
| Fluorescein Angiography | Not recorded | Covered |
| Fundus Photography | Not recorded | Covered |
| Gonioscopy | Not recorded | Covered |
| Visual Field Testing | Not recorded | Covered |
JK · Effective Oct 1, 2015
J9 · Effective Oct 1, 2015
J5 · Effective Oct 1, 2015
J8 · Effective Oct 1, 2015
J6 · Effective Apr 1, 2026
National · Effective Sep 3, 2026
J6 · Effective Jul 1, 2026
National · Effective Oct 1, 2025
J6 · Effective Apr 1, 2026
National · Effective Jun 4, 2026
J9 · Effective Oct 1, 2025
J5 · Effective Oct 1, 2025
| Policy | Effective | Status of H20.821 |
|---|---|---|
| Optic Nerve and Retinal Imaging Methods | May 17, 2023 | Covered |
| Policy | Effective | Status of H20.821 |
|---|---|---|
| Fundus Photography | Apr 15, 2026 | Covered |