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Thread: Premium Lenses

  1. #1

    Default Premium Lenses

    AAPC: Back to School
    Do any of your ASCs bill non medicare insurances for Premium Lenses? If so have you found payers who will reimburse V2787 or V2788?

  2. #2


    Our ASC bills them, but I have not found any insurances that pay on them. We collect the money for the lens at the time of service and if the insurance pays we refund the patient.

  3. #3


    Our ASC does not bill any other insurance besides Medicare (with appropriate modifier for non-covered item) for these lenses. We offer the patient paperwork to help them file with their insurance if they wish but have had only a couple that paid and they are very inconsistent in their payments. Patient would have one eye done and pay for the lens but when the other eye is performed, they deny. And everything on the information that the patient submits is the same. No rhyme or reason. Medicare denies to patient responsibility but we have pt sign ABN before surgery and explain that it is not covered.

  4. #4

    Default Abn & iol'

    Medicare/billing specifically state it is NOT required to have the pt sign an ABN for "statutorily excluded care or for service MDCR never covers." It is unnecessary paperwork, time consuming and a waste of time. Telling the patient we can bill MDCR - knowing they do not pay is ridiculous too. Very frustrating.
    Last edited by dru_rosen; 03-02-2015 at 02:55 PM. Reason: typo

  5. #5


    We do not have patient sign ABN's we do bill the insurance for them. BlueCross BlueShield of Nebraksa (NetBlue) pays for V2787 and V2788 and also Tricare when they are the primary payer pays for them! We always collect for the lenses before surgery and reimburse the patient if and when their insurance pays for them. Invoice for the lens is sent with the claim.

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