Wiki base lens codes

[Chance1105]

Specific to Medicare: If a patient purchases a progressive lens (V2781) are you able to split it out always using only a base lens such as V2200 (to cover all V2200 series lenses) even if the prescription is a V2203 for the RT & LT? (the amount charged to patient is under fee schedule) Is there such a thing as billing off of a base lens code no matter what the prescription reads?

 

[thomas7331]

Medicare's coding guidelines state "Only the single CPT code most accurately describing the procedure performed or service rendered should be reported." I'm not familiar with the specific details of lens coding, but as you described it, this doesn't sound correct since you would not be reporting the code that most accurately describes the type of lens that was provided to this patient.

 

[Chance1105]

Can you provide a link to where you found that information. I have been hunting for it and have not been successful.

 

[thomas7331]

Here's a link to the Medicare manual on provider communications regarding correct coding that contains this direction:

https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/com109c05.pdf