Ophthalmology and Optometry Coding Alert
Bill 92070 for Contacts for Keratoconus
Question: Can I bill for contacts? We have a Medicare patient with keratoconus who needs contacts. New York Subscriber Answer: You may be tempted to assign 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). But this is not the appropriate code for keratoconus patients (371.60-371.62). With this diagnosis, you should code 92070 (Fitting of contact lens for treatment of disease, including supply of lens). 92310 is for treating a refractive error, and Medicare does not cover the treatment of refractive problems. Advice for You Be the Coder and Reader Questions provided by Raequell Duran, president, Practice Solutions, Santa Barbara, Calif.
The kind of contact lens used to treat keratoconus is a bandage contact lens. Using 92070 in patients with keratoconus shows that the lens is for treatment of a medical condition, not a refractive condition.
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Bill 92070 for Contacts for Keratoconus
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