H36.89 coverage policies: Medicare and commercial payers

38 active Medicare policies list H36.89, and 3 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 H36.89

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-L34399

Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)

J15 · Effective Oct 1, 2015

LCD · NGS-J6-L33567

Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)

J6 · Effective Oct 1, 2015

LCD · NGS-JK-L33567

Ophthalmology: Posterior Segment Imaging (Extended Ophthalmoscopy and Fundus Photography)

JK · Effective Oct 1, 2015

LCD · CGS-J15-L34061

Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)

J15 · Effective Oct 1, 2015

LCD · NGS-J6-L34380

Scanning Computerized Ophthalmic Diagnostic Imaging (SCODI)

J6 · Effective Oct 1, 2015

LCD · NGS-JK-L34380

Commercial payer policies listing H36.89

3 policies from 1 payer

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

Anthem

Anthem policies listing H36.89, with the code’s status in each
Policy	Effective	Status of H36.89
Fundus PhotographyClinical Guideline · ANTHEM-CG-MED-47	Apr 15, 2026	Covered
Outpatient Laboratory-based Blood Glucose TestingClinical Guideline · ANTHEM-CG-LAB-30	Jul 1, 2026	Covered
Posterior Segment Optical Coherence TomographyClinical Guideline · ANTHEM-CG-MED-85	Jan 6, 2026	Covered