H35.042 coverage policies: Medicare and commercial payers

64 active Medicare policies list H35.042, 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 H35.042

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 · WPS-J5-L39905

Cataract Surgery

J5 · Effective Oct 13, 2024

LCD · WPS-J8-L39905

Cataract Surgery

J8 · Effective Oct 13, 2024

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 · CGS-J15-L37578

Micro-Invasive Glaucoma Surgery (MIGS)

J15 · Effective Mar 19, 2018

LCD · NORIDIAN-JE-L37373

Commercial payer policies listing H35.042

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 H35.042, with the code’s status in each
Policy	Effective	Status of H35.042
Extended OphthalmoscopyPayerPolicy · AMBETTER-CP-VP-26	Not recorded	Covered
Fluorescein AngiographyPayerPolicy · AMBETTER-CP-VP-28	Not recorded	Covered
Fundus PhotographyPayerPolicy · AMBETTER-CP-VP-29	Not recorded	Covered
GonioscopyPayerPolicy · AMBETTER-CP-VP-31	Not recorded	Covered