T85.22XA coverage policies: Medicare and commercial payers

23 active Medicare policies list T85.22XA, and 3 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 T85.22XA

LCD · CGS-J15-L33944

Blepharoplasty

J15 · Effective Oct 1, 2015

LCD · CGS-J15-L33946

Capsule Opacification Following Cataract Surgery: Discission and YAG Laser Capsulotomy

J15 · Effective Oct 1, 2015

LCD · CGS-J15-L34008

Computerized Corneal Topography

J15 · 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 · CGS-J15-L34181

Ophthalmic Biometry for Intraocular Lens Power Calculation

J15 · Effective Oct 1, 2015

LCD · NGS-J6-L33621

Ophthalmic Biometry for Intraocular Lens Power Calculation

J6 · Effective Oct 1, 2015

LCD · NGS-JK-L33621

Ophthalmic Biometry for Intraocular Lens Power Calculation

JK · Effective Oct 1, 2015

LCD · PALMETTO-JJ-L33467

Ophthalmology: Extended Ophthalmoscopy and Fundus Photography

JJ · Effective Oct 1, 2015

LCD · PALMETTO-JM-L33467

Commercial payer policies listing T85.22XA

3 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 T85.22XA, with the code’s status in each
Policy	Effective	Status of T85.22XA
Extended OphthalmoscopyPayerPolicy · AMBETTER-CP-VP-26	Not recorded	Covered
Medically Necessary Optical HardwarePayerPolicy · AMBETTER-CP-VP-06	Not recorded	Covered

Cigna

Cigna policies listing T85.22XA, with the code’s status in each
Policy	Effective	Status of T85.22XA
Intraocular Lens ImplantPayerPolicy · CIGNA-0125	Sep 15, 2026	Covered