H21.563 coverage policies: Medicare and commercial payers

35 active Medicare policies list H21.563, and 2 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 H21.563

LCD · CGS-J15-L33954

Cataract Extraction

J15 · Effective Oct 1, 2015

LCD · NGS-J6-L33558

Cataract Extraction

J6 · Effective Oct 1, 2015

LCD · NGS-JK-L33558

Cataract Extraction

JK · Effective Oct 1, 2015

LCD · FIRST_COAST-L38926

Cataract Extraction (including Complex Cataract Surgery)

J9 · Effective Jul 11, 2021

LCD · NOVITAS-JH-L35091

Cataract Extraction (including Complex Cataract Surgery)

JH · Effective Oct 1, 2015

LCD · NOVITAS-JL-L35091

Cataract Extraction (including Complex Cataract Surgery)

JL · Effective Oct 1, 2015

LCD · WPS-J5-L39905

Cataract Surgery

J5 · Effective Oct 13, 2024

LCD · WPS-J8-L39905

Cataract Surgery

J8 · Effective Oct 13, 2024

LCD · NORIDIAN-JE-L34203

Cataract Surgery in Adults

JE · Effective Oct 1, 2015

LCD · NORIDIAN-JF-L34203

Cataract Surgery in Adults

JF · Effective Oct 1, 2015

Commercial payer policies listing H21.563

2 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 H21.563, with the code’s status in each
Policy	Effective	Status of H21.563
External Ocular PhotographyPayerPolicy · AMBETTER-CP-VP-43	Not recorded	Covered
Visual Field TestingPayerPolicy · AMBETTER-CP-VP-63	Not recorded	Covered