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You’ve fit a patient with some great new specialty lenses, but now how do you get paid? This is a common, frustrating topic for many practitioners. In this article, we will break down the basics of billing and coding for specialty lens patients through a series of cases. Keep in mind, different insurance companies have different rules and recommendations for which codes to use, but here we will outline some of the basics to get you started.However, before we delve into the cases, it is important to know the available Current Procedural Terminology (CPT) codes. These contact lens codes are divided into two categories—contact lens fitting and contact lens materials—but often both are necessary. In addition, all practitioners will need to be familiar with International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM), provided by the Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS), for medical coding and reporting in the United States. Of most relevance will be the codes between H00 and H59, which cover diseases of the eye and adnexa.
However, depending on the health of the patients, other codes will be relevant as well. CONTACT LENS FITTING CODESHere is a list of the applicable CPT codes and definitions for contact lens fitting. The codes are published annually by the American Medical Association.92310 Contact lens fitting for corneal lenses, both eyes, except for aphakia. Use this code when you are fitting soft contact lenses or corneal GP lenses, unless the patient has aphakia.
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This is a bilateral code, so you would only bill this code once, even if you fit both eyes.92311 Contact lens fitting of a corneal lens for aphakia, one eye. Use this code when you are fitting a soft contact lens or corneal GP lens for aphakia.92312 Contact lens fitting of a corneal lens for aphakia, both eyes. Use this code if you are fitting a soft contact lens or corneal GP lens for a patient who has aphakia if you are fitting both eyes.92313 Contact lens fitting of a corneoscleral lens, both eyes. Use this code if you are fitting a patient with a corneoscleral lens, mini-scleral lens, or full scleral lens.92071 Fitting of a contact lens for treatment of ocular surface disease.
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Common uses of this code would be for a patient who has punctate keratitis due to dry eye, in which the practitioner utilizes a bandage contact lens. This code is only for the contact lens fitting portion, so be sure to bill for the supply of the lens separately.92072 Fitting of a contact lens for management of keratoconus, initial fitting.
Use this code when you are fitting a patient who has keratoconus, no matter what type of lens you select (soft lens, corneal GP, hybrid, scleral). This code can be a bit ambiguous: Do you only use this code when you first fit your patients?
What happens when they come back next year and are re-fit; then what code do you use? What does initial fitting mean? What if they were fit by another practitioner? Was that their “initial fitting”? If patients have worn contact lenses before, but they are a new patient in an office, would it be considered an initial fitting? The answer is unclear, as insurance companies have differing definitions and rules; however, there are many billing and coding articles, webinars, FAQs, patient letter samples, etc.
Available online.92499 Other ophthalmological services or procedures. Use this code when fitting a custom impression-based scleral lens.
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Epstein is internationally recognized for expertise in complex contact lens management and medical complications of contact lenses, dry eye, and anterior segment disease. He co-founded Phoenix Eye Care and The Dry Eye Center of Arizona and serves as the Director of Cornea - External Disease. Epstein also heads Ophthalmic Research Consultants of Arizona. He is a stock shareholder of NovaBay Pharmaceuticals and has received honoraria for consulting, performing research, speaking, and/or writing from Alcon, B+L, Bio-Tissue, Essilor, EyeEco, Oculus, PRN, NovaBay, Novartis, Sight Sciences, Shire, TearLab, and TearScience.
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