HCPCS C1839 is officially defined as "Iris prosthesis." HCPCS C1839 is referenced in 3 tracked payer policy changes from Regence BlueShield and Aetna. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for HCPCS C1839 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.
Effective January 1, 2027, this policy establishes that iris prosthesis devices (including CustomFlex Artificial Iris) are classified as investigational for all indications and therefore non-covered. Billing teams must ensure claims for CPT 66683 and HCPCS C1839 are processed as investigational/non-covered and members are informed of financial responsibility prior to service delivery.
Aetna considers artificial retina devices, such as the Argus II, and artificial iris devices, such as the CustomFlex Artificial Iris, experimental, investigational, or unproven because their effectiveness has not been established. The CPT, HCPCS and ICD-10 codes listed in the policy are not covered for the indications listed in the policy, which include anterior segment reconstruction, aniridia, post-operative or traumatic aphakia and other iris defects. The policy states that there is insufficient evidence that artificial retina devices result in improved useful vision, and that the available evidence on artificial iris use for aniridia is weak.
Aetna considers artificial retina devices, such as the Argus II, experimental, investigational, or unproven because the effectiveness of these approaches has not been established. Aetna also considers artificial iris devices, such as the CustomFlex Artificial Iris, experimental, investigational, or unproven for anterior segment reconstruction and for the treatment of aniridia, post-operative or traumatic aphakia, and other iris defects. The listed CPT, HCPCS and ICD-10 codes are not covered for the indications listed in the policy.
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