Ophthalmology and Optometry Coding Alert

Question: Which code should we use for monthly replacement toric contacts? We have been using V2599 (Contact lens, other type).

Indiana Subscriber

Answer: For toric monthly disposables -- prescribed for astigmatic patients -- report V2521 (Contact lens, hydrophilic, toric or prism ballast, per lens). Since monthly lenses are more than likely soft (hydrophilic), V2521 would be appropriate.

Don't expect payment from Medicare, however. The HCPCS manual says, "Hydrophilic contact lenses are covered by Medicare only for aphakic patients."

If the patient received toric gas-permeable lenses, report V2511 (Contact lens, gas permeable, toric, prism ballast, per lens), but this would probably not be a monthly contact.