Results 1 to 7 of 7

Thread: Bill Medicare for repair?

  1. #1
    Rising Star
    Join Date
    Jul 2011
    Location
    Cleveland
    Occupation
    Dispensing Optician
    Posts
    57

    Bill Medicare for repair?

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

    Thanks.

  2. #2
    Master Jedi King of the Lab's Avatar
    Join Date
    Jul 2012
    Location
    Los Angeles, CA.
    Occupation
    Optical Laboratory Technician
    Posts
    335
    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.
    Erik Zuniga, ABOC.

  3. #3
    Rising Star
    Join Date
    Jul 2011
    Location
    Cleveland
    Occupation
    Dispensing Optician
    Posts
    57
    I was talking about nosepad replacement, screws, etc..

    Quote Originally Posted by King of the Lab View Post
    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.

  4. #4
    My Brain Hurts jpways's Avatar
    Join Date
    Oct 2008
    Location
    NW PA
    Occupation
    Dispensing Optician
    Posts
    599
    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.
    Last edited by jpways; 01-13-2019 at 05:02 PM.

  5. #5
    Rising Star
    Join Date
    Jan 2017
    Location
    Hilo, Hawaii
    Occupation
    Dispensing Optician
    Posts
    63
    Are there any private insurance companies that allow you to bill for minor repairs like this?
    Last edited by Alex Camblor; 01-15-2019 at 10:51 PM.

  6. #6
    What's up? drk's Avatar
    Join Date
    Mar 2004
    Location
    Ohio
    Occupation
    Optometrist
    Posts
    7,674
    Good heavens, no.

  7. #7
    Optical Janitor OptiBoard Silver Supporter peyes's Avatar
    Join Date
    May 2000
    Location
    Saraland, Alabama
    Occupation
    Optical Retail
    Posts
    360
    Of course you can file any claim to any insurance. Getting paid is always the trick!

Thread Information

Users Browsing this Thread

There are currently 1 users browsing this thread. (0 members and 1 guests)

Similar Threads

  1. Tonopen Repair / Tono-Pen Repair
    By phoroptor_tech in forum Ophthalmic Optics
    Replies: 0
    Last Post: 03-21-2009, 08:21 PM
  2. Kill Bill
    By Jedi in forum Just Conversation
    Replies: 0
    Last Post: 10-14-2003, 01:12 PM
  3. Remembering Bill
    By Oha in forum General Optics and Eyecare Discussion Forum
    Replies: 0
    Last Post: 10-10-2003, 09:12 PM
  4. Bill does it again.......
    By John R in forum Just Conversation
    Replies: 13
    Last Post: 11-20-2000, 04:54 PM

Bookmarks

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
OptiBoard is proudly sponsored by:
Younger Optics and Vision Equipment