How do I bill for keratoconus?

How do I bill for keratoconus?

Keratoconus is coded on claims as follows:

  1. H18. 611-H18. 613 (Stable keratoconus, right/left/both eyes)
  2. H18. 621-H18. 623 (Unstable keratoconus, right/left/both eyes)

What is the CPT code for scleral lenses?

V2531
CPT code(s): 92310 (Prescription of Optical and Physical Characteristics of and Fitting of Contact Lens, with Medical Supervision of Adaptation; Corneal Lens, Both Eyes, Except for Aphakia)…FOLLOW THE STEPS.

CODE YOUR FEES
Scleral lens device V2531-LT $200
Total collected from insurance $500

What is the CPT code for RGP contact lenses?

92310
In addition to the basic eye examination, a contact lens fitting is reimbursable with CPT® codes 92071, 92072 and 92310 thru 92312 for recipients with medically necessary conditions.

Is 92071 considered a procedure?

CPT® 92071, Under Ophthalmological Examination and Evaluation Procedures. The Current Procedural Terminology (CPT®) code 92071 as maintained by American Medical Association, is a medical procedural code under the range – Ophthalmological Examination and Evaluation Procedures.

What is the diagnosis code for keratoconus?

611-613 Keratoconus. Keratoconus is a disease of the cornea. It is characterized by progressive thinning of the corneal stroma and a progressive steepening in the shape of the cornea.

Are scleral lenses covered by insurance?

Scleral lenses are not automatically covered by vision or medical insurance. Though most insurances will reimburse the costs for scleral lenses when medically necessary, the rates and restrictions tend to vary greatly from one vision insurance provider to the next.

What is a Corneoscleral lens?

Corneo-scleral lenses and semi-scleral lenses are much larger larger than conventional GP lenses and rest near the junction between the cornea and the sclera. Mini-scleral lenses vault over the entire corneal surface and rest on the anterior sclera.

What is CPT code V2520?

V2520—Contact Lens, Hydrophilic, Spherical, Per Lens.

Is 92071 a bilateral code?

Effective January 1, 2012, there is a new code, 92071 (Fitting of contact lens for treatment of ocular surface disease). Medicare defines this code as bilateral; bill once whether one or both eyes are treated. CPT instructs that the contact lens itself be reported separately as 99070 or an appropriate supply code.

What qualifies as medically necessary contacts?

Types of Contact Lenses Medical necessity exists when there is an underlying medical eye disease or condition, such as keratoconus, corneal transplantation, corneal scarring, Sjögren’s Syndrome, ocular graft-versus-host disease (GVHD), neurotrophic keratitis, trichiasis, or Stevens-Johnson syndrome.

What is the CPT code for contact lens exam?

Contact Lens Services CPT Code range 92310- 92326. The Current Procedural Terminology (CPT) code range for Ophthalmology Services and Procedures 92310-92326 is a medical code set maintained by the American Medical Association.

What is the CPT code for bandage contact lens?

Dr. Chou also uses the CPT code of 92070 for bandage contact lenses. “This is a per-eye code, so the modifier of RT, LT or 50 (both eyes) should accompany the claim,” he said.

What is the CPT code for contacts?

CPT Code 92070 was retired and replaced with the following codes: 92071: Fitting of contact lens for treatment of ocular surface disease. 92072: Fitting of contact lens for management of keratoconus, initial fitting only.

What is the CPT code for contact lens?

▸ Employ CPT 92071, which is the code for fitting a contact lens for the treatment of OSD. Be sure to indicate the specific eye (RT or LT) because this code is unilateral in nature.