Wiki Billing Medicaid for Postoperative Eyeglasses for Cataract Surgery

Messages
2
Best answers
0
I work in an ophthalmology office and am constantly billing post operative eyeglasses for cataract surgeries to DME and have had no problem getting them paid. (We use CPT codes V2303, V2305, etc. and ICD-10 code Z96.1). I have recently tried billing Medicaid for a pair of post operative eyeglasses for a patient's cataract surgery and they have denied it twice. (The second time I billed it I added the DOSs in Box 19). I called Medicaid and they told me that they could not help me out with the appropriate CPT code to bill for post op glasses. But they did tell me that V2303 only applies to children/young adults under the age of 20. On their website, under Medicaid vision benefits it says: "Adults (21 and older): Medically necessary eye examinations, eyeglasses and contact lenses ONLY following eye surgery. Does not require prior authorization, and surgery may have been performed at any time during the patient's life."

Any ideas on how to bill this??? I can't seem to find answers ANYWHERE!!
 
Not sure about your state. Its possible that for your state, Medicaid patients above the age of majority are not eligible for routine vision services. Have you had a conversation with your Medicaid provider to ask them about patient eligibility for the service?
 
Top