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CPT Code 92310 | Contact Lens Prescription And Fitting

CPT 92310 describes the prescription and fitting of contact lenses for both eyes, including training and any necessary revisions, with medical supervision, and does not apply to patients who have had cataract surgery. This service is separate from general ophthalmic services.

What Is CPT Code 92310?

CPT code 92310 is used for the prescription and fitting of contact lenses for both eyes, taking into account the optical and physical characteristics of the cornea.

The fitting process includes training the wearer and any necessary revisions of the lenses during this period.

This service must be performed by a medical provider and does not apply to aphakic patients due to cataract surgery.

Note that the prescription and fitting of contact lenses are considered separate from general ophthalmic services.”

Description

The CPT book describes CPT code 92310 as: “Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation; corneal lens, both eyes, except for aphakia.”

Procedure

The provider prescribes contact lenses for both eyes after determining the optical and physical characteristics of the cornea.

The fitting includes training of the wearer and incidental revision of the lenses during training.

Prescription and fitting of contact lenses are not part of the general ophthalmic services.

This service does not apply to patients who are aphakic as a result of cataract surgery. In addition, this service must be performed by the medical provider, not by a technician.

How To Use CPT 92310

CPT code 92310 must be performed by a medical provider and does not include the lenses’ cost.

Most medical plans will cover the cost of contact lenses when necessary for functional vision, such as after cataract surgery or for keratoconus. Still, they will not cover them to correct typical vision abnormalities such as nearsightedness or farsightedness.

Some insurance companies may have a policy that requires vision with glasses to be 20/70 or worse before they cover contact lenses. If the prescription is for an aphakic patient, use CPT 92311 for one eye or CPT 92312 for both eyes.

If an independent technician performs the fitting, use CPT 92314 for one eye, CPT 92315 for one eye in a patient with aphakia, or CPT 92316 for both eyes.

If the prescription is for a corneoscleral lens, use code 92313, and if an independent technician performs the fitting, use code 92317.

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