H40.1231 coverage policies: Medicare and commercial payers

75 active Medicare policies list H40.1231, 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 H40.1231

LCD · CGS-J15-L40355

Anterior segment intraocular nonbiodegradable drug-eluting system

J15

LCD · NGS-J6-L40362

Anterior segment intraocular nonbiodegradable drug-eluting system

LCD · NGS-JK-L40362

Anterior segment intraocular nonbiodegradable drug-eluting system

LCD · WPS-J5-L40384

Anterior segment intraocular nonbiodegradable drug-eluting system

LCD · WPS-J8-L40384

Anterior segment intraocular nonbiodegradable drug-eluting system

LCD · CGS-J15-L33954

Cataract Extraction

J15 · Effective Oct 1, 2015

LCD · FIRST_COAST-L38926

Cataract Extraction (including Complex Cataract Surgery)

J9 · Effective Jul 11, 2021

LCD · WPS-J5-L37205

Chemotherapy Drugs and their Adjuncts

J5 · Effective Sep 16, 2017

LCD · WPS-J8-L37205

Chemotherapy Drugs and their Adjuncts

J8 · Effective Sep 16, 2017

LCD · CGS-J15-L33999

Corneal Pachymetry

J15 · Effective Oct 1, 2015

Commercial payer policies listing H40.1231

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 H40.1231, with the code’s status in each
Policy	Effective	Status of H40.1231
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