How To Use CPT Code 92313

CPT 92313 describes the prescription and fitting of corneoscleral contact lenses, with medical supervision of adaptation. This article will cover the description, procedure, qualifying circumstances, appropriate usage, documentation requirements, billing guidelines, historical information, similar codes and billing examples.

1. What is CPT Code 92313?

CPT 92313 can be used to describe the prescription and fitting of corneoscleral contact lenses, with medical supervision of adaptation. This code is used when a medical provider determines the optical and physical characteristics of the cornea and prescribes corneoscleral lenses for both eyes. The fitting process includes training the wearer and making any necessary revisions to the lenses during the training period.

2. Official Description

The official description of CPT code 92313 is: ‘Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation; corneoscleral lens.’

3. Procedure

1. The medical provider assesses the patient’s cornea and determines the optical and physical characteristics required for the contact lenses.
2. Based on the assessment, the provider prescribes corneoscleral lenses for both eyes.
3. The fitting process includes training the wearer on how to adapt to the new lenses.
4. During the training period, the provider may make any necessary revisions to the lenses to ensure proper fit and comfort.

4. Qualifying circumstances

CPT 92313 is used when a medical provider prescribes corneoscleral lenses for both eyes after determining the optical and physical characteristics of the cornea. The fitting process includes training the wearer and making any necessary revisions to the lenses during the training period. It is important to note that this service must be performed by the medical provider and not by a technician.

5. When to use CPT code 92313

CPT code 92313 should be used when a medical provider prescribes and fits corneoscleral contact lenses for both eyes, with medical supervision of adaptation. This code should not be used for general ophthalmic services or when the fitting is performed by a technician.

6. Documentation requirements

To support a claim for CPT 92313, the medical provider must document the following information:

• Optical and physical characteristics of the cornea
• Date of the prescription and fitting
• Details of the training provided to the wearer
• Any revisions made to the lenses during the training period
• Signature of the medical provider

7. Billing guidelines

When billing for CPT 92313, ensure that the service is performed by a medical provider and not a technician. This code should be reported separately and should not be reported with other codes. It is important to check with the payer to determine if the cost of the lenses is covered when medical necessity is documented.

8. Historical information

CPT 92313 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates to the code since its addition.

9. Examples

1. A medical provider prescribing and fitting corneoscleral contact lenses for a patient with irregular corneas.
2. A medical provider training a patient on adapting to corneoscleral lenses after determining the optical and physical characteristics of their cornea.
3. A medical provider making revisions to corneoscleral lenses during the training period to ensure proper fit and comfort for the patient.
4. A medical provider prescribing and fitting corneoscleral contact lenses for a patient with corneal irregularities due to keratoconus.
5. A medical provider providing medical supervision of adaptation for corneoscleral lenses to a patient with corneal scarring.
6. A medical provider prescribing and fitting corneoscleral contact lenses for a patient with corneal dystrophy.
7. A medical provider training a patient on adapting to corneoscleral lenses after determining the optical and physical characteristics of their cornea.
8. A medical provider making revisions to corneoscleral lenses during the training period to ensure proper fit and comfort for the patient.
9. A medical provider prescribing and fitting corneoscleral contact lenses for a patient with corneal irregularities due to trauma.
10. A medical provider providing medical supervision of adaptation for corneoscleral lenses to a patient with corneal ectasia.