|
V2200 |
 |
Sphere, bifocal, plano to plus or minus 4.00d, per lens
| short | Lens spher bifoc plano 4.00d |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | | DME | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration |
|
|
|
|
V2201 |
|
Sphere, bifocal, plus or minus 4.12 to plus or minus 7.00d, per lens
| short | Lens sphere bifocal 4.12-7.0 |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | | DME | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration |
|
|
|
|
V2202 |
|
Sphere, bifocal, plus or minus 7.12 to plus or minus 20.00d, per lens
| short | Lens sphere bifocal 7.12-20. |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | | DME | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration |
|
|
|
|
V2203 |
|
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, .12 to 2.00d cylinder, per lens
| short | Lens sphcyl bifocal 4.00d/.1 |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | | DME | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration |
|
|
|
|
V2204 |
|
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 2.12 to 4.00d cylinder, per lens
| short | Lens sphcy bifocal 4.00d/2.1 |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | | DME | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration |
|
|
|
|
V2205 |
|
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, 4.25 to 6.00d cylinder, per lens
| short | Lens sphcy bifocal 4.00d/4.2 |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | | DME | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration |
|
|
|
|
V2206 |
|
Spherocylinder, bifocal, plano to plus or minus 4.00d sphere, over 6.00d cylinder, per lens
| short | Lens sphcy bifocal 4.00d/ove |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | | DME | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration |
|
|
|
|
V2207 |
|
Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere,.12 to 2.00d cylinder, per lens
| short | Lens sphcy bifocal 4.25-7d/. |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | | DME | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration |
|
|
|
|
V2208 |
|
Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 2.12 to 4.00d cylinder, per lens
| short | Lens sphcy bifocal 4.25-7/2. |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | | DME | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration |
|
|
|
|
V2209 |
|
Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, 4.25 to 6.00d cylinder, per lens
| short | Lens sphcy bifocal 4.25-7/4. |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | | DME | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration |
|
|
|
|
V2210 |
|
Spherocylinder, bifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens
| short | Lens sphcy bifocal 4.25-7/ov |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | | DME | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration |
|
|
|
|
V2211 |
|
Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens
| short | Lens sphcy bifo 7.25-12/.25- |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | | DME | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration |
|
|
|
|
V2212 |
|
Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens
| short | Lens sphcyl bifo 7.25-12/2.2 |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | | DME | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration |
|
|
|
|
V2213 |
|
Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens
| short | Lens sphcyl bifo 7.25-12/4.2 |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | | DME | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration |
|
|
|
|
V2214 |
|
Spherocylinder, bifocal, sphere over plus or minus 12.00d, per lens
| short | Lens sphcyl bifocal over 12. |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | | DME | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration |
|
|
|
|
V2215 |
|
Lenticular (myodisc), per lens, bifocal
| short | Lens lenticular bifocal |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | | DME | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration |
|
|
|
|
V2218 |
|
Aniseikonic, per lens, bifocal
| short | Lens aniseikonic bifocal |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | | DME | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration |
|
|
|
|
V2219 |
|
Bifocal seg width over 28 mm
| short | Lens bifocal seg width over |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | | DME | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration |
|
|
|
|
V2220 |
|
Bifocal add over 3.25d
| short | Lens bifocal add over 3.25d |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | | DME | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration |
|
|
|
|
V2221 |
|
Lenticular lens, per lens, bifocal
| short | Lenticular lens, bifocal |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration | | DME | 2.0 | 3 Date of Service Edit: Clinical | Anatomic Consideration |
|
|
|
|
V2299 |
|
Specialty bifocal (by report)
| short | Lens bifocal speciality |
| RVU | | CPT Modifier | Physician Component | Facility Practice | Nonfacility Practice | Professional Liability Insurance | Total Facility | Total Nonfacility | Global Period |
|---|
| 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | 0.0 | XXX |
|
| MUE | | Location | Value | Ajudication Indicator | Rationale |
|---|
| PRA | 0.0 | 3 Date of Service Edit: Clinical | CMS Policy | | OPH | 2.0 | 3 Date of Service Edit: Clinical | Nature of Equipment | | DME | 2.0 | 3 Date of Service Edit: Clinical | Nature of Equipment |
|
|
|