HCPCS Range Vision Supplies

• 1 Disposable contact lens, per lens ( S0500 )

• 2 Single vision prescription lens (safety, athletic, or sunglass), per lens ( S0504 )

• 3 Bifocal vision prescription lens (safety, athletic, or sunglass), per lens ( S0506 )

• 4 Trifocal vision prescription lens (safety, athletic, or sunglass), per lens ( S0508 )

• 5 Non-prescription lens (safety, athletic, or sunglass), per lens ( S0510 )

• 6 Daily wear specialty contact lens, per lens ( S0512 )

• 7 Color contact lens, per lens ( S0514 )

• 8 Scleral lens, liquid bandage device, per lens ( S0515 )

• 9 Safety eyeglass frames ( S0516 )

• 10 Sunglasses frames ( S0518 )

• 11 Polycarbonate lens (list this code in addition to the basic code for the lens) ( S0580 )

• 12 Nonstandard lens (list this code in addition to the basic code for the lens) ( S0581 )

• 13 Integral lens service, miscellaneous services reported separately ( S0590 )

• 14 Comprehensive contact lens evaluation ( S0592 )

• 15 Dispensing new spectacle lenses for patient supplied frame ( S0595 )

• 16 Phakic intraocular lens for correction of refractive error ( S0596 )