Need help with a Vcode!

[eyeconic74]

I am from Nebraska and I am being told by our Medicaid system that we can't use V2799 for a "high power" up charge. They claim there is a code out there for it, but they won't tell us what it is! They won't let us divide the charge and include it in the Vcode for each lens even with a modifier! Anyone have any ideas????

[Sledzinator]

As far as I know the Vcode number changes according to power. For example the 2100 will go up to a 2101 or 2102 or higher depending on power. Maybe you could bill differently when the number goes up.

[DazeyReign]

SV? Bifocal? Trifocal?
It'll be 21XX, 22XX, or 23XX depending on the lens and what the over power is.

[becc971]

If you send me your e-mail i can send you a sheet of what we use for medicare claims, there may be a useful vcode on there *edited because i wanted to add more to this*

Typically you need to itemize out using the correct Vcode associated w/the RX for SV, Bi or Tri focal first, then if they do a progressive upgrade use the progressive code. i'm not sure there is a code that works just for "higher prescriptions" not one that i know of anyway.

again, happy to send you that list which itemizes the codes out for you based on the RX powers :)

[HarryChiling]

I am from Nebraska and I am being told by our Medicaid system that we can't use V2799 for a "high power" up charge. They claim there is a code out there for it, but they won't tell us what it is! They won't let us divide the charge and include it in the Vcode for each lens even with a modifier! Anyone have any ideas????

V2799 is for miscellaneous vision services, if you are using a specialty lens there are codes that end with 99 in bifocal and trifocal that allow you to provide a report for a specialty lens. Otherwise you may consider coding the lens according to power and then splitting the price out for all the additional features of the lens, materials, coatings, etc.

[rdcoach5]

http://www.hcpcs.info/V_Codes/default.htm

[TLG]

V2782 - Lens, index 1. 54 to 1. 65 plastic or 1. 60 to 1. 79 glass, excludes polycarbonate, per lens
V2783 - Lens, index greater than or equal to 1. 66 plastic or greater than or equal to 1. 80 glass, excludes polycarbonate, per lens

[rbanting69]

There is a code V2199 that can be used to indicate higher powers, but it runs along the V21XX codes to designate powers. I can't think of any to specify an additional fee for dealing with a higher power. Maybe V2782, 83, 84? Although these are just material codes.

[eyeconic74]

As far as I know the Vcode number changes according to power. For example the 2100 will go up to a 2101 or 2102 or higher depending on power. Maybe you could bill differently when the number goes up.

We do submit the correct power code, however when we submit we have to send invoice copies. On our invoices our labs have an additional charge for powers over lets say +/- 4 diaptors. Usually we would just divide this charge and include it in the charge per lens. Our Medicaid says we can't do that and that we need a seperate charge for the high power fee and it can't be V2799. Once again we have been told (by Medicaid) that a "V code" exsists out there for this very instance but they refuse to tell us what it is or where to look for it.

[jpways]

Ask the insurance company if they will let you Use V2X00 for the base lens charge (or V2X03 if the base charge is compound) [X=1,2, or 3 depending on the lens type] and then use the higher power upcharge (V2X01, 2X02, 2X04-2X14) or V2X99 for the high power or you can ask your lab if there's anyway for them to rewrite their invoices.

[HarryChiling]

Try 2797, it relates to the material instead of a service like the 2799.