Wiki deluxe frame (V2025)

[mary.kulig@ct.gov]

Does anyone know if there is any specific or required criteria needed in order to bill this code V2025, deluxe frame?

 

[Cheezum51]

Deluxe frame

Medicare will pay for a "standard frame" after cataract surgery. You'll have to find out what the reimbursement is for that through your local carrier for DME.

To bill for the deluxe frame, it is the difference in price between the standard and deluxe frames the patient chooses. They've chosen a deluxe frame if it costs more than what the DME payment is for the standard frame.

If they chose a $150 frame and DME only pays $50, the patient pays the $100 difference. When you bill it, you do the following:

V2020 $50
V2025 $100

Make sure you fill out an ABN form with the specifics and have the patient sign it.