How To Use CPT Code 92326

CPT 92326 describes the replacement of contact lenses due to wear and tear, patient discomfort, loss of lens, or other reasons. 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 92326?

CPT 92326 can be used to describe the replacement of contact lenses by a healthcare provider. This code is used when the provider prescribes the replacement of contact lenses due to wear and tear, patient discomfort, loss of lens, or other reasons.

2. Official Description

The official description of CPT code 92326 is: ‘Replacement of contact lens.’

3. Procedure

1. The healthcare provider examines the patient’s eyes using a flashlight, ophthalmoscope, or slit lamp.
2. The provider hydrates the soft contact lenses using saline solution.
3. Each lens is then removed and replaced by the provider.

4. Qualifying circumstances

CPT 92326 can be used when a patient requires the replacement of contact lenses due to wear and tear, patient discomfort, loss of lens, or other reasons. The provider must examine the patient’s eyes using a flashlight, ophthalmoscope, or slit lamp. The provider must also hydrate the soft contact lenses using saline solution before removing and replacing them.

5. When to use CPT code 92326

CPT code 92326 should be used when a healthcare provider prescribes the replacement of contact lenses for a patient. This code should be used when the provider examines the patient’s eyes and replaces the lenses. It should not be used for other procedures or services unrelated to contact lens replacement.

6. Documentation requirements

To support a claim for CPT 92326, the healthcare provider must document the following information:

• Patient’s need for contact lens replacement
• Specific reason for replacement, such as wear and tear, patient discomfort, or loss of lens
• Date of the procedure
• Details of the examination, including the use of a flashlight, ophthalmoscope, or slit lamp
• Hydration of the soft contact lenses using saline solution
• Removal and replacement of each lens

7. Billing guidelines

When billing for CPT 92326, ensure that the procedure is performed by a healthcare provider. Report the appropriate side (RT or LT) if applicable. CPT code 92326 should not be reported with other contact lens codes. It is important to accurately document the procedure and provide any necessary supporting documentation.

8. Historical information

CPT 92326 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 visits an ophthalmologist due to discomfort caused by their contact lenses. The ophthalmologist examines the patient’s eyes, hydrates the lenses with saline solution, and replaces them.
2. A patient loses one of their contact lenses and seeks a replacement. The optometrist examines the patient’s eyes, removes the remaining lens, and replaces both lenses.
3. A patient’s contact lenses have become worn out and are causing irritation. The optician examines the patient’s eyes, hydrates the lenses, and replaces them with new ones.
4. A patient experiences a change in prescription and requires new contact lenses. The optometrist examines the patient’s eyes, removes the old lenses, and replaces them with the updated prescription.
5. A patient’s contact lenses have expired and need to be replaced. The optician examines the patient’s eyes, removes the expired lenses, and provides new ones.
6. A patient’s contact lenses have become damaged and need to be replaced. The ophthalmologist examines the patient’s eyes, removes the damaged lenses, and replaces them with new ones.
7. A patient’s contact lenses are causing discomfort and need to be replaced. The optometrist examines the patient’s eyes, hydrates the lenses, and replaces them with a different brand or type.
8. A patient’s contact lenses have become scratched and need to be replaced. The optician examines the patient’s eyes, removes the scratched lenses, and provides new ones.
9. A patient’s contact lenses have become dislodged and need to be replaced. The ophthalmologist examines the patient’s eyes, removes the dislodged lenses, and replaces them.
10. A patient’s contact lenses have become dirty and need to be replaced. The optometrist examines the patient’s eyes, hydrates the lenses, and replaces them with clean ones.