Lens Services:
92070 With 371.6x Focuses on Medical Necessity for Fitting Keratoconic Lenses
Published on Tue Oct 11, 2011
Follow this strategy and earn $67 for each contact lens procedure.You know you can't bill Medicare for regular refractive contact lenses, but you can expect reimbursement for contact lenses for patients presenting with keratoconus and aphakia -- if you know these expert rules of the road.Prove Medical Necessity for Keratoconus PatientsSituation: A 16-year-old patient presents with distorted and blurred vision along with glare and light sensitivity. The ophthalmologist diagnoses keratoconus (371.60-371.62) and fits special contact lenses to correct the problem. You know that 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) isn't right because the patient's carrier considers it to be a refractive error correction. Is there a more specific code you can use to describe the procedure?Solution: To avoid denials when the ophthalmologist prescribes a contact lens to treat keratoconus, use 92070 (Fitting [...]
