I have had progressive lenses (Hoya ECP) for several years. My optometrist always billed them as CPT code V2300 (trifocal lenses) and my insurance company (Carefirst Blue Cross Blue Shield of MD) always paid the claims. I switched to a new optometrist this year. His office used a different CPT code V2781 (progressive lenses) and the claim was rejected. Our insurance plan does not specifically cover progressive lenses. They cover single vision, bifocal, and trifocal lenses. My new optometrist will not resubmit the claim as trifocal lenses because he said it would be "insurance fraud." Aren't progressive lenses essentially no-line bifocals or trifocals? Varilux lenses have been around since the late 50's. Wouldn't you think my insurance company would be paying for them by now?? I think it is just a matter of how the claim is coded as to whether they will pay. They said if my optometrist agrees to provide additional information to them, then they will reconsider the claim. They said the code V2781 is "too generic." Any suggestions on how to get Blue Cross to pay this claim?
Bookmarks