Bill Medicare for repair?

[kdw613]

Does anyone know if there is a way to code and bill Medicare for an Eyeglass repair?

Thanks.

[King of the Lab]

Do mean like a frame replacement? Or are you really talking about like a nose pad or screw replacement?

Medicare usually only pays for the Comprehensive portion of an eye exam or post cataract surgery glasses.

[kdw613]

I was talking about nosepad replacement, screws, etc..

Do mean like a frame replacement? Or are you really talking about like a nose pad or screw replacement?

Medicare usually only pays for the Comprehensive portion of an eye exam or post cataract surgery glasses.

[jpways]

How would you prove medical necessity if you find a code?
There are only 2 times that medicare considers eyewear medically necessary
1. pseudophakia (1 time after each surgery, assuming that there is a large time difference between the 2 surgeries, otherwise 1 time)
2. aphakia (either congenital or acquired, as many times as necessary)
If its case #1, I don't see a way that you could get Medicare to accept the claim as the claim for the initial eyewear has already been made. If its case #2, it should be theoretically possible as you could argue that this is a cost saving measure as opposed to a new pair of eyeglasses, but I don't believe there is anything in any current Medicare literature that allows either V2797 or V2799 (the 2 codes that I can find that have a chance of being relevant) to be medically necessary.

[Alex Camblor]

Are there any private insurance companies that allow you to bill for minor repairs like this?

[drk]

Good heavens, no.

[peyes]

Of course you can file any claim to any insurance. Getting paid is always the trick!