H43.13 coverage policies: Medicare and commercial payers

37 active Medicare policies list H43.13, 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 H43.13

LCD · CGS-J15-L33954

Cataract Extraction

J15 · Effective Oct 1, 2015

LCD · NGS-J6-L33558

Cataract Extraction

J6 · Effective Oct 1, 2015

LCD · NGS-JK-L33558

Cataract Extraction

JK · 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-L37578

Micro-Invasive Glaucoma Surgery (MIGS)

J15 · Effective Mar 19, 2018

LCD · NORIDIAN-JE-L37373

MRI and CT Scans of the Head and Neck

JE · Effective Oct 8, 2018

LCD · NORIDIAN-JF-L37373

MRI and CT Scans of the Head and Neck

JF · Effective Oct 8, 2018

LCD · PALMETTO-JJ-L34426

Ophthalmic Angiography (Fluorescein and Indocyanine Green)

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L34426

Ophthalmic Angiography (Fluorescein and Indocyanine Green)

JM · Effective Oct 1, 2015

Commercial payer policies listing H43.13

6 policies from 2 payers

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

Ambetter

Ambetter policies listing H43.13, with the code’s status in each
Policy	Effective	Status of H43.13
Extended OphthalmoscopyPayerPolicy · AMBETTER-CP-VP-26	Not recorded	Covered
Fluorescein AngiographyPayerPolicy · AMBETTER-CP-VP-28	Not recorded	Covered
Fundus PhotographyPayerPolicy · AMBETTER-CP-VP-29	Not recorded	Covered
Visual Field TestingPayerPolicy · AMBETTER-CP-VP-63	Not recorded	Covered

Aetna

Aetna policies listing H43.13, with the code’s status in each
Policy	Effective	Status of H43.13
Optic Nerve and Retinal Imaging MethodsPayerPolicy · AETNA-CPB-0344