H40.061 coverage policies: Medicare and commercial payers

53 active Medicare policies list H40.061, and 6 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 H40.061

LCD · NGS-J6-L33558

Cataract Extraction

J6 · Effective Oct 1, 2015

LCD · NGS-JK-L33558

Cataract Extraction

JK · Effective Oct 1, 2015

LCD · PALMETTO-JJ-L34413

Cataract Surgery

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L34413

Cataract Surgery

JM · 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-L33999

Corneal Pachymetry

J15 · Effective Oct 1, 2015

LCD · NGS-J6-L33630

Corneal Pachymetry

J6 · Effective Oct 1, 2015

LCD · NGS-JK-L33630

Corneal Pachymetry

JK · Effective Oct 1, 2015

LCD · PALMETTO-JJ-L34512

Corneal Pachymetry

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L34512

Commercial payer policies listing H40.061

6 policies from 3 payers

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

Ambetter

Ambetter policies listing H40.061, with the code’s status in each
Policy	Effective	Status of H40.061
Extended OphthalmoscopyPayerPolicy · AMBETTER-CP-VP-26	Not recorded	Covered
Fundus PhotographyPayerPolicy · AMBETTER-CP-VP-29	Not recorded	Covered
GonioscopyPayerPolicy · AMBETTER-CP-VP-31	Not recorded	Covered
Visual Field TestingPayerPolicy · AMBETTER-CP-VP-63	Not recorded	Covered

Aetna

Aetna policies listing H40.061, with the code’s status in each
Policy	Effective	Status of H40.061
YAG Laser in Ophthalmology and Other Selected IndicationsPayerPolicy · AETNA-CPB-0354