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Wiki Medicaid billing 92370 & 92340

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calexander1265

Networker
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Mint Hill, NC
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I am trying to find documentation that states the 92370 and 92340 should not be billed together. I have lot's of denials from Medicaid where they pay the 92370 and deny the 92340. This makes sense to me since the 92370 by definition is "repair and refitting spectacles; except for aphakia" and 92340 is defined as "Fitting Spectacles except for aphakia, monofocal. So both codes are for fitting of spectacles.

Thank you
Cheryl Alexander, CPC, CRC, COPC
Financial Services Manger
 
The wording for the 92340 seems to apply to the initial fitting of a new pair of monofocal glasses. Whereas the 92370 definition seems to apply to repairing and readjusting an existing pair of glasses for a patient.

Therefore, it would not be appropriate to bill them together for the same date of service for a patient.
 
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