Wiki Specific to refractive lens coding: Could someone please share an example of an upgrade within a HCPCS code such as V2750? Would it be 4 total units?

[Chance1105]

Example: physician orders V2750 but there is no medical need, patient also wants V2750 on backside of lens. An ABN is obtained. Would this be an example of an upgrade within a HCPCS code with a total of 4 untis of V2750?

 

[jgossett]

Although I have never come across it, the definition says per lens. I would code it with a total of 2

 

[Chance1105]

Although I have never come across it, the definition says per lens. I would code it with a total of 2

This is where I get confused then because it is an upgrade within in a HCPCS and the instructions (to my understanding) are to code it like the example below.

Line 1: V2750 GA RT (upgrade to backside noglare)

Line 2: V2750 GK RT (anti reflective coating per lens)

Line 3: V2750 GA LT (upgrade to backside noglare)

Line 4: V2750 GK LT (anti reflective coating per lens)

I might be completely misunderstanding the upgrade within a HCPCS code.

https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/clm104c20.pdf (section 120)