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Ask a Rev Cycle Expert: Billing for Contact Lenses?

Question:

We are billing HCPCS code V2520 Contact lens, hydrophilic, spherical, per lens and are submitting 2 boxes of 6 lenses each with a quantity of 12. We are getting denials that we are over the Medically Unlikely Edit (MUE) established for the HCPCS code. Should we be billing per box?

Answer:

Billing per each is correct. Medicare will only cover one pair of contact lenses furnished after cataract surgery. Otherwise, contacts are not a covered Medicare benefit and should be self-pay.

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