Changes to Billing for Medicare Post-cataract Eyeglasses

Date: April 17, 2019

The Medicare Durable Medical Equipment (DME) Medicare Administrative Contractors (MAC) have issued a joint instruction that changes how you report post-cataract eyeglasses on claims.  The change is effective for dates of service on or after 03/01/2019.

Claims for lenses must include RT (right eye) and LT (left eye).  Previously, when the code for RT and LT were the same, the DME MACs instructed us to bill on one line with RTLT and a quantity of 2 when the codes were the same for each eye.  This new instruction changes this.  Now, even when the lens codes are the same for each side of the glasses, each lens must be billed as its own line item with RT or LT and a quantity of 1.  For example, a pair of bifocal lenses would be billed as V2203-RT and V2203-LT on two lines (each line with a unit of “1”).

To view the article instructions, link here.  Corcoran’s comprehensive monograph on post-cataract eyeglasses is being updated to include these changes; subscribers can access the updated monograph on our website.  Not a subscriber?  Purchase the monograph here.

We are happy to assist providers and groups in any way with QPP-related reporting issues or questions as well as other coverage topics, which include proper code selection, chart reviews, and payer action questions.  Please contact us.  We can also provide training on these or other subjects.  You can reach us via the link to our main webpage or at the phone number below.  You can also download our “App”, Corcoran 24/7, which can be separately accessed via one of the links below.

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