How To Use CPT Code 92358

CPT 92358 describes the temporary prosthesis service for aphakia, which involves the implantation of a temporary lens into the eye to restore vision in patients with the absence of a lens. 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 92358?

CPT 92358 is used to describe the temporary prosthesis service for aphakia. This code is used when a provider inserts a temporary lens into the patient’s eye to restore vision. Aphakia refers to the absence of the lens in the eye, which can be due to surgical removal, a wound, or congenital absence.

2. Official Description

The official description of CPT code 92358 is: ‘Prosthesis service for aphakia, temporary (disposable or loan, including materials).’ This code encompasses the insertion of a temporary lens into the patient’s eye to address the absence of a lens.

3. Procedure

1. The provider begins by assessing the patient’s condition and determining the need for a temporary lens to restore vision.
2. A temporary lens is selected and inserted into the patient’s eye.
3. The provider ensures that the lens is properly positioned and adjusted to optimize vision.
4. The patient is monitored for any complications or discomfort following the insertion of the temporary lens.
5. If necessary, the provider may make adjustments or provide additional instructions to the patient regarding the care and maintenance of the temporary lens.

4. Qualifying circumstances

CPT 92358 is applicable to patients with aphakia, which refers to the absence of the lens in the eye. This condition can occur due to surgical removal, a wound, or congenital absence. The temporary prosthesis service is aimed at restoring vision in these patients. It is important to note that this code specifically covers the temporary insertion of a lens, whether it is disposable or on loan, including the necessary materials.

5. When to use CPT code 92358

CPT code 92358 should be used when a provider performs the temporary prosthesis service for aphakia by inserting a temporary lens into the patient’s eye. This code is appropriate for cases where the patient requires a temporary solution to restore vision. It is important to ensure that the service provided aligns with the specific requirements outlined in the code description.

6. Documentation requirements

To support a claim for CPT 92358, the provider must document the following information:

• The patient’s diagnosis of aphakia
• The need for a temporary prosthesis service
• The specific details of the temporary lens used, including whether it is disposable or on loan
• The date of the procedure
• Any adjustments or instructions provided to the patient
• The provider’s signature

7. Billing guidelines

When billing for CPT 92358, it is important to ensure that the service provided aligns with the code description. Report the appropriate side (RT for right or LT for left) if applicable. Note that the concept of bilateral does not apply to contact lens codes. It is also important to consider any specific guidelines or requirements from the payer when submitting the claim.

8. Historical information

CPT 92358 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 with aphakia undergoes the temporary prosthesis service, and a provider inserts a temporary lens into their eye to restore vision.
2. Following surgical removal of the lens, a patient with aphakia receives the temporary prosthesis service, and a provider inserts a temporary lens to address the absence of the lens.
3. A patient with congenital aphakia receives the temporary prosthesis service, and a provider inserts a temporary lens to restore vision.
4. After sustaining an eye injury resulting in aphakia, a patient undergoes the temporary prosthesis service, and a provider inserts a temporary lens to address the absence of the lens.
5. A patient with aphakia due to a wound receives the temporary prosthesis service, and a provider inserts a temporary lens to restore vision.
6. Following a previous temporary lens insertion, a patient with aphakia requires another temporary prosthesis service, and a provider inserts a new temporary lens to address the absence of the lens.
7. A patient with aphakia receives the temporary prosthesis service, and a provider inserts a disposable temporary lens to restore vision.
8. For a patient with aphakia, a provider performs the temporary prosthesis service and inserts a loaned temporary lens to address the absence of the lens.
9. A patient with aphakia undergoes the temporary prosthesis service, and a provider inserts a temporary lens, providing instructions on its care and maintenance.
10. Following the diagnosis of aphakia, a patient receives the temporary prosthesis service, and a provider inserts a temporary lens to restore vision.