H57.11 coverage policies: Medicare and commercial payers

11 active Medicare policies list H57.11, and 1 commercial payer policy lists 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 H57.11

LCD · PALMETTO-JJ-L34425

Magnetic Resonance Imaging of the Head and Neck

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L34425

Magnetic Resonance Imaging of the Head and Neck

JM · Effective Oct 1, 2015

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 · FIRST_COAST-L34021

Sedimentation Rate, Erythrocyte

J9 · Effective Oct 1, 2015

LCD · WPS-J5-L34615

Visual Fields

J5 · Effective Oct 1, 2015

LCD · WPS-J8-L34615

Visual Fields

J8 · Effective Oct 1, 2015

Article · A56729

Billing and Coding: Magnetic Resonance Imaging of the Head and Neck

National · Effective Oct 1, 2026

Article · A57204

Billing and Coding: MRI and CT Scans of the Head and Neck

National · Effective Oct 1, 2026

Article · A57657

Billing and Coding: Sedimentation Rate, Erythrocyte

J9 · Effective Oct 1, 2024

Article · A57483

Billing and Coding: Visual Fields

Commercial payer policies listing H57.11

1 policy from 1 payer

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

UnitedHealthcare

UnitedHealthcare policies listing H57.11, with the code’s status in each
Policy	Effective	Status of H57.11
Intracanalicular and Intravitreal Corticosteroid ImplantsPayerPolicy · UHC-POL-intravitreal-corticosteroid-implants	Aug 1, 2026	Covered