Visual Field Examination
J9 · Effective Oct 1, 2015
2 active Medicare policies list H53.039, 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.
Free account. Policy pages stay open to everyone.
J9 · Effective Oct 1, 2015
J9 · Effective Oct 1, 2025
4 policies from 3 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
| Policy | Effective | Status of H53.039 |
|---|---|---|
| Acupuncture and Dry Needling | Apr 5, 2023 | Covered |
| Orthoptic Vision Therapy | Jul 14, 2023 | Covered |
| Policy | Effective | Status of H53.039 |
|---|---|---|
| Preventive (Routine) Eye Examination Attachment A: Refractive Hardware | Not recorded | Covered |
| Policy | Effective | Status of H53.039 |
|---|---|---|
| Dichoptic Digital Therapy for Amblyopia | Apr 15, 2026 | Covered |