Dexamethasone Intracanalicular Ophthalmic Insert (Dextenza®)

Dextenza (dexamethasone intracanalicular ophthalmic insert) is considered reasonable and necessary for treatment of ocular inflammation and pain following ophthalmic surgery, including cataract surgery, and is an alternative to topical corticosteroid eye drops. Use is contraindicated in patients with active corneal, conjunctival, or canalicular infections (including epithelial herpes simplex keratitis/dendritic keratitis, vaccinia, varicella, mycobacterial, fungal infections, and dacryocystitis), and intraocular pressure should be monitored during treatment. Each insert delivers 0.4 mg dexamethasone over about 30 days; the policy does not state explicit repeat-use frequency limits and repeat placement requires individual review.

"Dextenza is covered for treatment of ocular inflammation following ophthalmic surgery."

Sign up to see full coverage criteria, indications, and limitations.