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.
Disclaimer: This information was current at the time of its publishing and is designed to provide accurate information in regard to the subject matter covered. Vitalware does not accept any responsibility or liability with regard to any errors, omissions, misuses, or misinterpretation by the reader. It is not intended to take the place of either the written policies or regulations. We encourage you to review the specific regulations and other interpretive materials as necessary. All CPT® codes are trademarked by the American Medical Association (AMA) and all revenue codes are copyrighted by the American Hospital Association (AHA).