How To Use CPT Code 92352

CPT 92352 describes the process of fitting eyeglasses with a specific focal length for patients who have undergone cataract surgery. 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 92352?

CPT 92352 can be used to describe the fitting of eyeglasses with a specific focal length for patients who have had their native crystalline lens removed, typically through cataract surgery. This code is specifically for the fitting of the eyeglasses, taking into account measurements of the patient’s facial features and aligning the lenses to the patient’s visual axis to ensure optimal vision.

2. Official Description

The official description of CPT code 92352 is: ‘Fitting of spectacle prosthesis for aphakia; monofocal.’

3. Procedure

1. The fitting process begins with determining the patient’s refractive state, which is covered by code 92015.
2. Measurements of the patient’s facial features are taken to ensure proper alignment of the lenses.
3. The eyeglass frames are adjusted to fit comfortably and align with the patient’s visual axis.
4. The lenses are selected and fitted to provide the appropriate focal length for the patient’s needs.
5. The patient tries on the eyeglasses and adjustments are made as necessary to ensure optimal vision.
6. The physician must prescribe the eyeglasses and sign the order for Medicare coverage.

4. Qualifying circumstances

CPT 92352 is used for patients who have undergone cataract surgery and require eyeglasses with a specific focal length. The physician must prescribe the eyeglasses and sign the order for Medicare coverage. Medicare covers the cost of standard frames and lenses, even if the cataract surgery occurred before the patient was eligible for Medicare. Medicare also covers the cost of both lenses, even if only one eye had cataract surgery.

5. When to use CPT code 92352

CPT code 92352 should be used when fitting eyeglasses with a specific focal length for patients who have undergone cataract surgery. It is important to note that this code is strictly for the fitting of the eyeglasses and does not cover the determination of the refractive state, which is covered by code 92015.

6. Documentation requirements

To support a claim for CPT 92352, the following documentation is required:

• Prescription and order for the eyeglasses, signed by the physician
• Measurements of the patient’s facial features
• Details of any adjustments made to the frames or lenses
• Documentation of the patient trying on the eyeglasses and any necessary modifications

7. Billing guidelines

When billing for CPT 92352, ensure that the fitting of the eyeglasses is performed by a qualified healthcare professional. Medicare covers 80% of the cost, and the patient is responsible for the remaining 20%. If the patient upgrades beyond standard frames, Medicare will only cover the cost of standard frames.

8. Historical information

CPT 92352 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 who has undergone cataract surgery requires eyeglasses with a specific focal length. The physician prescribes the eyeglasses, and a qualified healthcare professional performs the fitting, ensuring proper alignment and optimal vision.
2. Following cataract surgery, a patient needs eyeglasses with a specific focal length. The physician signs the order for the eyeglasses, and a qualified healthcare professional fits the frames to the patient’s facial features and aligns the lenses to the visual axis.
3. After cataract surgery, a patient requires eyeglasses with a specific focal length. The physician prescribes the eyeglasses, and a qualified healthcare professional performs the fitting, making necessary adjustments to ensure comfort and optimal vision.
4. A patient who has had their native crystalline lens removed through cataract surgery needs eyeglasses with a specific focal length. The physician signs the order for the eyeglasses, and a qualified healthcare professional fits the frames and aligns the lenses to the patient’s visual axis.
5. Following cataract surgery, a patient requires eyeglasses with a specific focal length. The physician prescribes the eyeglasses, and a qualified healthcare professional performs the fitting, taking measurements of the patient’s facial features and ensuring proper alignment of the lenses.