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New DMEPOS Specialty Code for Ocularists

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  • In CMS
  • August 27, 2010
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Effective Jan. 1, 2011, the Centers for Medicare & Medicaid Services (CMS) will establish durable medical equipment prosthesis, orthotics and supplies (DMEPOS) specialty code B5 for ocularists.
The American Society of Ocularists defines an ocularist as a “carefully trained technician skilled in the arts of fitting, shaping, and painting ocular prostheses.” In addition to creating ocular prostheses, the ocularist shows the patient how to handle and care for them, and provides long-term care through periodic examinations.
Patients who need to be referred to an ocularist usually fall into the following categories:

  • Recent enucleation/evisceration
  • Problems with an existing prosthesis
  • Blind eyes requiring a scleral shell
  • Congenital anophthalmia/microphthalmia

Patients with existing ocular prostheses often need to be referred to the ocularist for problems with either the surface condition of the prosthesis or problems with the fit of the prosthetic eye or scleral shell.
Services provided by the ocularist include:

  • Cleaning
  • Polishing
  • Enlargement
  • Reduction
  • Replacement

Due to the requirements of most insurance policies, a written prescription from the referring physician or other appropriate eye care specialist often is required.

No Responses to “New DMEPOS Specialty Code for Ocularists”

  1. Sharon Wilson says:

    Will the B5 be a modifer? I am a CPC and manager Cox Ocular Prosthetics. At the moment we use only
    v2623 prosthetic eye
    v2327 Scleral Cover Shell
    v2628 and
    L8042 for Orbital Prosthesis and L8049 for repair of Orbital
    Sharon Wilson