How To Use CPT Code 92370

CPT 92370 describes the repair and refitting of spectacles for patients who do not have aphakia, the absence of a lens in the eye. 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 92370?

CPT 92370 can be used to describe the repair and refitting of spectacles for patients who do not have aphakia. This code is used when a provider makes adjustments or repairs to eyeglasses for individuals who do not have the absence of a lens in their eye. It does not include repairs for aphakic patients.

2. Official Description

The official description of CPT code 92370 is: ‘Repair and refitting spectacles; except for aphakia.’

3. Procedure

1. The provider assesses the patient’s spectacles and determines the need for repair or refitting.
2. Measurements of anatomical facial characteristics are taken to ensure proper fitting.
3. Laboratory specifications are written to guide the repair or refitting process.
4. The spectacles are adjusted to align with the patient’s visual axes and anatomical topography.
5. Final adjustments are made to ensure optimal fit and comfort for the patient.

4. Qualifying circumstances

CPT 92370 is applicable to patients who require repair and refitting of spectacles but do not have aphakia. Aphakia refers to the absence of the lens of an eye, either due to surgical removal, wound, or congenital absence. Patients with aphakia should be reported with a different code, such as CPT 92371. The repair and refitting of spectacles for patients without aphakia fall under the scope of CPT 92370.

5. When to use CPT code 92370

CPT code 92370 should be used when a provider performs repairs or refitting of spectacles for patients who do not have aphakia. It is important to ensure that the patient’s condition aligns with the qualifying circumstances for this code. If the patient has aphakia, a different code should be used to accurately reflect the service provided.

6. Documentation requirements

To support a claim for CPT 92370, the provider must document the following information:

• Patient’s condition and absence of aphakia
• Measurements of anatomical facial characteristics
• Laboratory specifications for repair or refitting
• Date and details of the repair or refitting procedure
• Final adjustments made to ensure proper fit

7. Billing guidelines

When billing for CPT 92370, ensure that the patient does not have aphakia. Report materials as a separate service component and not as part of the service of fitting spectacles. It is important to follow the specific guidelines provided by the payer to ensure accurate billing and reimbursement.

8. Historical information

CPT 92370 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 provider making adjustments and repairs to a patient’s spectacles to ensure proper fit and comfort.
2. A patient seeking refitting of their spectacles due to changes in their facial characteristics.
3. A provider writing laboratory specifications for the repair of a patient’s damaged spectacles.
4. A provider adjusting the visual axes and anatomical topography of a patient’s spectacles for optimal performance.
5. A patient requiring final adjustments to their spectacles to improve their vision and comfort.
6. A provider repairing and refitting spectacles for a patient who does not have aphakia.
7. A patient seeking repairs for their spectacles after accidental damage.
8. A provider refitting spectacles for a patient with changes in their prescription.
9. A patient requiring adjustments to their spectacles due to discomfort or poor fit.
10. A provider repairing and refitting spectacles for a patient with a scratched lens.