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25.3.3.6 Fluocinolone Acetonide
The fluocinolone acetonide (Retisert) intravitreal implant will be considered for reimbursement for ASCs and hospitals when services are rendered in the inpatient hospital and/or outpatient hospital settings for clients 12 years of age and older.
Procedure code 1-J7311 is only payable with a posterior uveitis diagnosis (36320) of more than six months in duration and only when the condition has been unresponsive to oral or systemic medication treatment. Prior authorization is required.
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