Drugs and Biologicals, Coverage of, for Label and Off-Label Uses
J6 · Effective Oct 1, 2015
65 active Medicare policies list H35.051, and 9 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 Jan 30, 2022
J9 · Effective Feb 2, 2018
JH · Effective Jan 25, 2018
JL · Effective Jan 25, 2018
JE · Effective Oct 8, 2018
JF · Effective Oct 8, 2018
J15 · Effective Oct 1, 2015
9 policies from 2 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of H35.051 |
|---|---|---|
| Age-Related Macular Degeneration | Feb 20, 2024 | Covered |
| Genetic Testing | Feb 27, 2024 | Covered |
| Macular/Foveal Translocation | Jun 7, 2023 | Covered |
| Transpupillary Thermal Therapy | Jul 14, 2023 | Covered |
| Verteporfin (Visudyne) Photodynamic Therapy | Jun 29, 2023 | Covered |
JJ · Effective Oct 1, 2015
JM · Effective Oct 1, 2015
JJ · Effective Oct 1, 2015
JM · Effective Oct 1, 2015
J15 · Effective Oct 1, 2015
J6 · Effective Oct 1, 2015
JK · Effective Oct 1, 2015
J15 · Effective Oct 1, 2015
J6 · Effective Oct 1, 2015
JK · Effective Oct 1, 2015
JH · Effective Oct 1, 2015
JL · Effective Oct 1, 2015
J15 · Effective Oct 1, 2015
J9 · Effective Oct 1, 2015
J6 · Effective Oct 1, 2015
JK · Effective Oct 1, 2015
JJ · Effective Oct 1, 2015
JM · Effective Oct 1, 2015
J5 · Effective Oct 1, 2015
J8 · Effective Oct 1, 2015
J6 · Effective Mar 16, 2017
JK · Effective Mar 16, 2017
J5 · Effective Jul 17, 2017
J8 · Effective Jul 17, 2017
J9 · Effective Oct 1, 2015
J5 · Effective Oct 1, 2015
J8 · Effective Oct 1, 2015
J15 · Effective Oct 1, 2015
J6 · Effective Oct 1, 2015
JK · Effective Oct 1, 2015
J6 · Effective Jul 1, 2026
JL · Effective Oct 1, 2024
J9 · Effective Oct 1, 2024
National · Effective Nov 16, 2023
National · Effective Nov 6, 2025
National · Effective Oct 1, 2026
National · Effective Oct 1, 2025
National · Effective May 28, 2026
National · Effective Oct 1, 2025
J6 · Effective Apr 1, 2026
National · Effective Jun 4, 2026
J6 · Effective Apr 1, 2026
National · Effective Mar 26, 2026
J6 · Effective Jul 1, 2026
J6 · Effective Apr 1, 2026
National · Effective Aug 6, 2026
National · Effective Oct 1, 2025
J5 · Effective Apr 30, 2026
JL · Effective Oct 1, 2025
J9 · Effective Oct 1, 2025
J6 · Effective Apr 1, 2026
J5 · Effective Oct 1, 2025
J9 · Effective Oct 1, 2025
J5 · Effective Oct 1, 2025
J6 · Effective Apr 1, 2026
National · Effective Nov 6, 2025
| Policy | Effective | Status of H35.051 |
|---|
| Extended Ophthalmoscopy | Not recorded | Covered |
|---|---|---|
| Fluorescein Angiography | Not recorded | Covered |
| Fundus Photography | Not recorded | Covered |
| Gonioscopy | Not recorded | Covered |