H40.242 coverage policies: Medicare and commercial payers

56 active Medicare policies list H40.242, 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 H40.242

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 · 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

LCD · NGS-J6-L33630

Corneal Pachymetry

J6 · Effective Oct 1, 2015

LCD · NGS-JK-L33630

Commercial payer policies listing H40.242

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 H40.242, with the code’s status in each
Policy	Effective	Status of H40.242
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