Wiki Crystalens intraocular Lens

[RSnodgrass]

Phacoemulsifiatioin and implantation of Crystalens intraocular lens .... does anyone have an opinion on this... would it be covered under 66984?

 

[mbort]

depends on your carrier contracts. Medicare includes this as they only pay for NTIOLS and the Crystalens is not on that NTIOL list. For those IOL's that are on the list, Medicare will pay an additional $50 (ie: ZCB00, SN60WF, ZA9003, etc)

 

[CVelez]

Crystalens P-C IOLs are not covered by Medicare. However, if the beneficiary elects to have this type of lens they are responsible for the portion that exceeds the charge for a conventional IOL. For P-C IOL use HCPCS V2788 and A-C IOLS use HCPCS V2787 both with GY modifier. This information is available on CMS website under change request 3927.
You do not have to use an ABN as this does not fall into any Medicare benefit category. CMS does encourage the use of Exclusion from Medicare Benefits.

Charla