How To Use CPT Code 92316

CPT 92316 describes the prescription of corneal contact lenses for both eyes in a patient with aphakia, with medical supervision of adaptation and direction of fitting by an independent technician. 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 92316?

CPT 92316 can be used to describe the prescription of corneal contact lenses for both eyes in a patient with aphakia, with medical supervision of adaptation and direction of fitting by an independent technician. This code is used when the provider specifies the optical and physical characteristics of the lenses and supervises the fitting process.

2. Official Description

The official description of CPT code 92316 is: ‘Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and direction of fitting by independent technician; corneal lens for aphakia, both eyes.’

3. Procedure

1. The provider assesses the patient’s condition and determines the need for corneal contact lenses for both eyes due to aphakia.
2. The provider prescribes the optical and physical characteristics of the lenses, including power, curvature, size, flexibility, and gas permeability.
3. An independent technician performs the adaptation and fitting of the lenses under the medical supervision of the provider.
4. The provider ensures that the lenses are properly fitted and adjusted to meet the patient’s needs.
5. The provider may provide additional instructions and guidance to the patient regarding the use and care of the lenses.
6. Follow-up appointments may be scheduled to monitor the patient’s progress and make any necessary adjustments to the lenses.

4. Qualifying circumstances

CPT 92316 is used for patients who are aphakic, meaning they have the absence of the lens of an eye, either due to surgical removal, wound, or congenital absence. The provider must prescribe corneal contact lenses for both eyes and supervise the adaptation and fitting process by an independent technician.

5. When to use CPT code 92316

CPT code 92316 should be used when the provider prescribes corneal contact lenses for both eyes in a patient with aphakia and supervises the adaptation and fitting process by an independent technician. This code should not be used for other types of contact lenses or for patients who do not have aphakia.

6. Documentation requirements

To support a claim for CPT 92316, the provider must document the following information:

• Patient’s diagnosis of aphakia
• Prescription details, including the optical and physical characteristics of the lenses
• Date of the prescription
• Supervision of the adaptation and fitting process by an independent technician
• Any additional instructions or guidance provided to the patient
• Follow-up appointments, if applicable

7. Billing guidelines

When billing for CPT 92316, ensure that the provider prescribes corneal contact lenses for both eyes in a patient with aphakia and supervises the adaptation and fitting process by an independent technician. There are no specific guidelines regarding reporting CPT 92316 with other codes. However, it is important to accurately document the services provided to support the billing of this code.

8. Historical information

CPT 92316 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 patient with aphakia in both eyes receives a prescription for corneal contact lenses from an ophthalmologist. The ophthalmologist supervises the adaptation and fitting process by an independent technician.
2. A provider diagnoses a patient with congenital absence of the lens in both eyes and prescribes corneal contact lenses. The provider supervises the adaptation and fitting process by an independent technician.
3. An individual undergoes surgical removal of the lenses in both eyes and requires corneal contact lenses. The provider specifies the optical and physical characteristics of the lenses and supervises the adaptation and fitting process by an independent technician.
4. A patient with aphakia due to a wound in both eyes is prescribed corneal contact lenses by an optometrist. The optometrist supervises the adaptation and fitting process by an independent technician.
5. A provider prescribes corneal contact lenses for both eyes in a patient with congenital aphakia. The provider ensures the proper adaptation and fitting of the lenses by an independent technician.
6. A patient who had surgical removal of the lenses in both eyes receives a prescription for corneal contact lenses from an ophthalmologist. The ophthalmologist supervises the adaptation and fitting process by an independent technician.
7. An individual with aphakia in both eyes requires corneal contact lenses. The provider prescribes the lenses and supervises the adaptation and fitting process by an independent technician.
8. A provider diagnoses a patient with congenital absence of the lens in both eyes and prescribes corneal contact lenses. The provider ensures the proper adaptation and fitting of the lenses by an independent technician.
9. A patient undergoes surgical removal of the lenses in both eyes and needs corneal contact lenses. The provider specifies the optical and physical characteristics of the lenses and supervises the adaptation and fitting process by an independent technician.