Ophthalmology and Optometry Coding Alert

Tip: If a tech does the fitting, your coding strategy changes. Experienced ophthalmology coders know that getting claims paid for contact lenses and other prescriptive medical devices can be one of the most vexing challenges in a typical workday. Here's our expert advice to help you steer clear of common errors and get on the path to contact lens claims success. 1. Home In on Codes for Lens and Fitting When an ophthalmologist, rather than a technician, provides contact lens prescription and fitting, you should choose from the following codes: 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 92311 -- ... corneal lens for aphakia, one eye 92312 -- ... corneal lens for aphakia, both eyes 92313 -- ... corneoscleral lens. Example: For most patients, you should bill the initial fitting with code 92310. CPT® guidelines: [...]