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Thread: Bill Medicare for repair?

  1. #1
    OptiBoard Professional
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    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
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    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
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    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
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    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
    OptiBoardaholic OptiBoard Bronze Supporter
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    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
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    Good heavens, no.

  7. #7
    OptiWizard OptiBoard Silver Supporter peyes's Avatar
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    Of course you can file any claim to any insurance. Getting paid is always the trick!

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