HCPCS J7311: Fluocinolone Acetonide Intravitreal Implant (Retisert) 0.01 mg
HCPCS Level II code J7311 denotes the intravitreal implant of fluocinolone acetonide (Retisert), 0.01 mg. The code captures delivery of a sustained‑release corticosteroid implant used in chronic posterior segment inflammatory eye disease and related ophthalmic conditions. Nationally, implants such as this are clinically significant because they represent high-cost, procedure‑driven therapies administered in specialized settings and often subject to payer-specific coverage rules.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context, typical sites of service, and the types of benchmarks and policy considerations commonly applied to high-cost ophthalmic implants. The publication outlines how this HCPCS Level II code is used for billing intravitreal implant placement and what stakeholders typically review when assessing coverage and reimbursement for such therapies.
The piece provides actionable reference material for revenue cycle and clinical leaders: definitions and coding precision for J7311, expected service settings, and the scope of payer involvement. Data not available in the input for payer-specific rates, utilization benchmarks, taxonomies, ICD‑10 pairings, and related codes are noted as unavailable in source material; readers will learn which elements are routinely required for claims adjudication and policy reviews.
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Billing Code Overview
HCPCS Level II code J7311 represents the injection of fluocinolone acetonide intravitreal implant (Retisert), 0.01 mg. This code describes a one-time intravitreal implant procedure delivering a corticosteroid directly into the eye for chronic posterior segment inflammatory conditions.
Service Type: Intravitreal implant administration
Typical Site of Service: Ambulatory surgical center or hospital outpatient department, where ophthalmic implant procedures and retinal surgeries are performed.
Data not available in the input.