Intracanalicular and Intravitreal Corticosteroid Implants
Defines UnitedHealthcare medical benefit policy for use of specific intracanalicular and intravitreal corticosteroid implant products for ophthalmologic indications and the conditions under which authorization is considered proven or not medically necessary.
Replaced language indicating Dextenza is 'proven and medically necessary when all of the [listed] criteria are met' with 'Dextenza is proven when all of the [listed] criteria are met'.
Replaced language indicating Iluvien/Ozurdex/Retisert/Yutiq is 'proven and medically necessary when all of the [listed] criteria are met' with 'Iluvien/Ozurdex/Retisert/Yutiq is proven when all of the [listed] criteria are met'.
Revised coverage criteria; removed criterion requiring Iluvien/Ozurdex/Retisert/Yutiq be prescribed by or in consultation with an ophthalmologist.
Added multiple ICD-10 codes for Non-Infectious Uveitis Affecting the Posterior Segment of the Eye.
Removed ICD-10 diagnosis codes G89.18 and H05.00 from Ocular Inflammation and Pain Following Ophthalmic Surgery.
Updated Clinical Evidence and References sections to reflect current information.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.