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Question regarding coding for fitting of contact lenses

  1. Default Question regarding coding for fitting of contact lenses
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    Hi everyone ~
    Can anyone provide some clarfication on coding for fitting of contact lenses by an optical dispenser? I have a provider who is bundling the fitting fee into the total charge of the HCPC code for lenses. This does not appear correct to me.
    I have been looking at the following two codes as possibilites of the correct codes:
    HCPC V2799 - Vision service, miscellaneous.
    CPT 92314 - Prescription of optical and phyiscal characteristics of contact lens, with medial supervision of adaptation and direction of fitting by independent technician; corneal lens, both eyes except for aphakia.

    Can anyone with experience in this field shed some light on the industry standard for coding this fitting fee?


  2. Default
    I work for an optometrist and we bill 92310. Our office policy for contacts includes 3 visits. The 1st one is with the Optometrist for the fitting of the contact lens. The 2nd visit is a training session, where the pt comes in & is given the prescription contacts & the Optometrist Tech trains the pt on how to put the contacts in, how to remove them & proper care & handling of the lenses. The pt is sent home with a 'trial' pair. The pt then returns in a wk & if they are happy with the lenses, the final prescription is written. Alot of insurances will not pay for the dispensing fee. And the pts we are usually fitting are seen for 'routine' diags such as myopia, presbyopia, astigmatism and are usually pts who want the option of having glasses & contacts. There are other codes for fitting in relation to medical eye conditions but usually for such fittings & materials the insurance company requires a prior authorization to be done by the Optometrist...for example, for keratoconus.
    We also use CPT 92070 (Fitting of contact lens for treatment of disease, including supply of lens) but this CPT is related to injury codes...such as the pt has a foreign body removal & the optometrist inserts a contact lens as a 'bandage' & will usually remove the lens the following day. This code isnt appropriate for use of prescription lenses relating to a medical condition such as keratoconus. I hope this helps.

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