Glass CPT Code?

[OptiChick21]

Does anyone know, is there a CPT code ("v-code") for Standard Glass 1.523??

Thanks!

[chip anderson]

Oh my God! Don't tell me you are trying to give the patient real lenses he can see out of! Surely you could have use some kind of high tech super zoomo stuff, run the price way up and tole him how dangerous real glasses are.

Chip

[Jana Lewis]

Does anyone know, is there a CPT code ("v-code") for Standard Glass 1.523??

Thanks!

V2100?

That's what I've always used. :)

[jpways]

There is no separate V code for glass (since it's a basic material) you would just use your standard V21XX, V22XX, or V23XX depending the the lens type and Rx. The only time you would use a separate code with glass is for something like slab off (V2710).

Here's a complete list of V codes if you don't have them (from DMERC region D)
https://www.noridianmedicare.com/dme...apter16_v.html

[OptiChick21]

See that's what I always thought too...

But the lab charges more for glass, so we have a "add on" charge for glass (over plastic) in our pricing to cover this.

So, when we submit to VSP for example, should that cost be covered? (as part of the basic lens)?

How do we bill for this??

[OptiChick21]

Oh my God! Don't tell me you are trying to give the patient real lenses he can see out of! Surely you could have use some kind of high tech super zoomo stuff, run the price way up and tole him how dangerous real glasses are.

Chip

Chip, your name suits you perfectly because I think you have a real chip in your shoulder sometimes!! LoL

I think you might be assuming this is the first time I'm using glass? Possibly because I am young(er)? Dunno, maybe i'm taking this wrong... :hammer:

[jpways]

While it is true today that glass is more expensive in plastic, you have to understand that when the rules were written they weren't. If we're talking about DMERC then the rules cover it. However, if we're just talking about VSP, what are you worrying about? If anyone has to eat the costs it's you lab (yes that's really the position VSP and its ilk have put us in, someone has to pay, and it's not going to be them). Just use the appropriate options code, and yes there is not one for a standard glass lens, which if you're using Eyefinity it's posting the codes anyway.

[HarryChiling]

S1002U9 - Customized Item - Glass

The S1002 is for a customized item description and the U9 modifier is to specify glass. I've never tried it with VSP, but it should work.

[jpways]

I would be careful on using the S1002 code in submitting a claim with this code, if you do a search on it you see that medicare considers it a non-covered service. So, check with the insurance company first. If you submit a claim
Where XX is your total lens charge and GL is your Glass upcharge
HCPCS Price Qty
V2103 XX-GL 2
S1002 GL 2

and the scheduled reimbursment is greater than XX-GL , you may be giving up a portion of your payment. But, you should always check with the insurance company to see if a code you've never used before is a covered service and what the reimbursment is for that code, should it be covered.

Of course if the scheduled reimbursment is less than XX-GL it doesn't matter what you do, because it's not like you'll be getting paid any more.

But before I keep going any further, the point I'm trying to make is to find out what the reimbursment schedule is for the codes you want to use (the fewer, the better) and see if you're getting reimbursed at a level you deem acceptable before adding any additional codes.

[HarryChiling]

I would be careful on using the S1002 code in submitting a claim with this code, if you do a search on it you see that medicare considers it a non-covered service. So, check with the insurance company first. If you submit a claim
Where XX is your total lens charge and GL is your Glass upcharge
HCPCS Price Qty
V2103 XX-GL 2
S1002 GL 2

and the scheduled reimbursment is greater than XX-GL , you may be giving up a portion of your payment. But, you should always check with the insurance company to see if a code you've never used before is a covered service and what the reimbursment is for that code, should it be covered.

Of course if the scheduled reimbursment is less than XX-GL it doesn't matter what you do, because it's not like you'll be getting paid any more.

Great addition, thank you.

[sharpstick777]

I didn't know glass was still available for RX lenses~