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January 25, 2022 - Updated 04.30.24

Triamcinolone Acetonide Injectable Suspension, for Suprachoroidal Use (Xipere™) Billing and Coding Instructions

Xipere™ is an FDA-approved corticosteroid injection for the treatment of macular edema associated with uveitis. Xipere is available as a single-use suprachoroidal microinjector.

Coding for Xipere™

Report the following information on your claim to Medicare:

  • HCPCS code J3299 for the drug
  • CPT code 67516 for the injection procedure
  • ICD-10 diagnosis code for uveitis AND macular edema that aligns with FDA-labeled use for this product, such as:
    Non-infectious Uveitis
    • Anterior uveitis
      • Primary iridocyclitis (H20.011, H20.012, H20.013)
      • Recurrent acute iridocyclitis (H20.021, H20.022, H20.023)
    • Intermediate uveitis (H30.21, H30.22, H30.23)
    • Panuveitis (H44.111, H44.112, H44.113)
    • Posterior uveitis
      • Exudative retinopathy (H35.021, H35.022, H35.023)
      • Retinal vasculitis (H35.061, H35.062, H35.063)
      • Focal chorioretinal inflammation, juxtapapillary (H30.011, H30.012, H30.013)
      • Focal chorioretinal inflammation of posterior pole (H30.021, H30.022, H30.023)
      • Focal chorioretinal inflammation, peripheral (H30.031, H30.032, H30.033)
      • Focal chorioretinal inflammation, macular or paramacular (H30.041, H30.042, H30.043)
      • Disseminated chorioretinal inflammation posterior pole (H30.111, H30.112, H30.113)
      • Disseminated chorioretinal inflammation, peripheral (H30.121, H30.122, H30.123)
      • Disseminated chorioretinal inflammation, generalized (H30.131, H30.132, H30.133)
      • Other chorioretinal inflammations (H30.891, H30.892, H30.893)
      • Harada’s disease (H30.811, H30.812, H30.813)
      • Vogt-Koyanagi Syndrome (H20.821, H20.822, H20.823)
    Macular Edema
    • Cystoid macular degeneration (H35.351, H35.352, H35.353)
    • Retinal edema (H35.81)

NOTE: Unlabeled use of the drug is subject to review on a case-by-case basis and must meet the reasonable and necessary criteria described in the Medicare Benefit Policy Manual (Pub. 100-02), chapter 15, section 50.4.2 – Unlabeled Use of DrugExternal PDF.

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