13 commercial payer policies list J7313. 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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13 policies from 13 payers
Summary of the payer’s published policy. Not a coverage determination — confirm with the payer before submitting.
Codes labeled “Inferred from policy title” are not listed in the policy document; Backwork attached them because the policy title names the drug.
| Policy | Effective | Status of J7313 |
|---|---|---|
| Fluocinolone Acetonide Intra-vitreal Implant (Retisert, Yutiq and Iluvien) | Jan 5, 2024 | Covered |
| Policy | Effective | Status of J7313 |
|---|---|---|
| Intravitreal, Punctum Corticosteroid Implants (e.g., Retisert, Yutiq, Iluvien, Ozurdex, and Dextenza) | Not recorded | Covered with conditionsInferred from policy title |
| Policy | Effective | Status of J7313 |
|---|---|---|
| Intravitreal, Punctum, and Intracameral Implants | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J7313 |
|---|---|---|
| Intravitreal, Punctum, and Intracameral Implants | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J7313 |
|---|---|---|
| Intravitreal, Punctum, and Intracameral Implants | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J7313 |
|---|---|---|
| Intravitreal, Punctum, and Intracameral Implants | Jan 1, 2026 | Covered |
| Policy | Effective | Status of J7313 |
|---|---|---|
| Fluocinolone Acetonide Implant (Iluvien) | Dec 1, 2016 | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J7313 |
|---|---|---|
| Fluocinolone Acetonide Intravitreal Implant (Iluvien)Effective 12/01/2018 - 10/31/2019 | Dec 1, 2018 | Prior auth requiredInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J7313 |
|---|---|---|
| Corticosteroids for ophthalmic injection (Dextenza, Iluvien, Ozurdex, Retisert, Xipere, Yutiq); CP.PHAR.385 | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J7313 |
|---|---|---|
| Fluocinolone acetonide implants (Iluvien, Retisert and Yutiq) | Not recorded | Covered with conditionsInferred from policy title. Not listed in the policy document; attached because the policy title names the drug. |
| Policy | Effective | Status of J7313 |
|---|---|---|
| Intracanalicular and Intravitreal Corticosteroid Implants | Aug 1, 2026 | Covered |
| Policy | Effective | Status of J7313 |
|---|---|---|
| Intracanalicular and Intravitreal Corticosteroid Implants | Aug 1, 2026 | Covered |
| Policy | Effective | Status of J7313 |
|---|---|---|
| Intracanalicular and Intravitreal Corticosteroid Implants | Aug 1, 2026 | Covered |