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24.3.17.9 Fluocinolone Acetonide (Retisert)
Fluocinolone acetonide (procedure code 1-J7311) is a benefit of the CSHCN Services Program.
ASCs, HASCs, and hospitals may submit procedure code 1-J7311 for the fluocinolone acetonide intravitreal implant when services are rendered in the inpatient hospital and/or outpatient hospital settings for clients 12 years of age and older.
In addition, procedure code 1-J7311 is only considered for reimbursement with a posterior uveitis (36320) diagnosis 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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