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Medicare Glasses After Cataract

  1. #1
    Default Medicare Glasses After Cataract
    Medical Coding Books
    I just want to make sure I understand how to bill for the glasses if the patient chooses Deluxe frames-

    From what I read, when billing Medicare for deluxe frames after cataract, on the claim you would list one line with V2020 with your cost then the next line would be V2025 with the difference between the Medicare allowed amount and the cost of the deluxe frames? Do you need a modifier on the V2025?

    And what is Medicare's allowed amount for V2020- I can't find that code on Trailblazer's website (I'm in TX)


  2. #2
    When billing for post cataract glasses it doesn't go to part b Medicare, it is sent to your DME (durable medical equipment). On your DME's website you can find the reimbursement for V codes.

    You will need to have an ABN signed by the patient so they know what is not going to be covered by Medicare. you'll need to append the ABN modifier to V2025.
    Jennifer DeWitte, CPC, CPC-P, CPB, AAPC Fellow
    Newport Center Surgical
    Coding & Billing Department
    Vice President
    AAPC Fullerton, CA Chapter

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