How To Use CPT Code 92342

CPT 92342 describes the fitting of spectacles with multifocal lenses, excluding bifocals, for patients who do not have aphakia. 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 92342?

CPT 92342 involves the fitting of spectacles with multifocal lenses, specifically those that are not bifocals. These lenses have separate areas of varying focal lengths to address different vision needs, such as far vision, near or reading vision, and an intermediate distance. This code is used for patients who do not have aphakia, which is the absence of the lens of the eye.

2. Official Description

The official description of CPT code 92342 is: ‘Fitting of spectacles, except for aphakia; multifocal, other than bifocal.’

3. Procedure

1. The provider assesses the patient’s vision needs and determines the appropriate multifocal lenses.
2. The provider fits the spectacles with the selected multifocal lenses, ensuring they are suitable for the patient’s specific vision requirements.
3. The patient tries on the spectacles to ensure proper fit and comfort.
4. The provider makes any necessary adjustments to the spectacles to optimize vision correction.
5. The patient is educated on the proper use and care of the spectacles.
6. Follow-up appointments may be scheduled to monitor the patient’s satisfaction and address any concerns.

4. Qualifying circumstances

CPT 92342 is applicable to patients who require spectacles with multifocal lenses, excluding bifocals, and do not have aphakia. Multifocal lenses are used to address different vision needs, such as far vision, near or reading vision, and an intermediate distance. The provider must ensure that the spectacles are suitable for the patient’s specific vision requirements.

5. When to use CPT code 92342

CPT code 92342 should be used when fitting spectacles with multifocal lenses, excluding bifocals, for patients who do not have aphakia. It is important to accurately document the specific type of lenses used and the patient’s vision needs to support the use of this code.

6. Documentation requirements

To support a claim for CPT 92342, the provider must document the following information:

• Patient’s diagnosis or need for spectacles with multifocal lenses
• Type of multifocal lenses used
• Date of the fitting
• Details of any adjustments made to the spectacles
• Instructions provided to the patient regarding the use and care of the spectacles

7. Billing guidelines

When billing for CPT 92342, ensure that the fitting of spectacles with multifocal lenses, excluding bifocals, is accurately documented. It is important to note that this code should not be reported with codes 92340 to 92341, which are specific to aphakia. Additionally, consider the location of the service and any specific billing requirements from payers.

8. Historical information

CPT 92342 was added to the Current Procedural Terminology system on January 1, 1990. There have been no updates or changes to the code since its addition.

9. Examples

1. A patient without aphakia requires spectacles with multifocal lenses to address their far vision, near or reading vision, and an intermediate distance.
2. A provider fits spectacles with multifocal lenses, excluding bifocals, for a patient who needs correction for both near and far vision.
3. A patient with varying vision needs, including far vision, near or reading vision, and an intermediate distance, receives spectacles with multifocal lenses.
4. A provider fits spectacles with multifocal lenses, specifically trifocals, for a patient who requires correction for far vision, near or reading vision, and an intermediate distance.
5. A patient who does not have aphakia receives spectacles with multifocal lenses to address their specific vision needs.
6. A provider fits spectacles with progressive multifocal lenses for a patient who requires correction for far vision, near or reading vision, and an intermediate distance.
7. A patient with occupational vision needs, such as far vision, near or reading vision, and an intermediate distance, receives spectacles with occupational multifocal lenses.
8. A provider fits spectacles with multifocal lenses, excluding bifocals, for a patient who requires correction for both near and far vision.
9. A patient without aphakia receives spectacles with multifocal lenses to address their specific vision requirements.
10. A provider fits spectacles with multifocal lenses, specifically other multifocal lenses, for a patient who needs correction for far vision, near or reading vision, and an intermediate distance.