How To Use CPT Code 92371

CPT 92371 describes the repair and refitting of spectacles, specifically for patients with aphakia, which is 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 92371?

CPT 92371 can be used to describe the repair and refitting of spectacles for patients who have aphakia, meaning they are missing a lens in their eye. This code is specifically for cases where the provider needs to make adjustments or repairs to the spectacles to ensure proper fit and functionality for the patient.

2. Official Description

The official description of CPT code 92371 is: ‘Repair and refitting spectacles; spectacle prosthesis for aphakia.’

3. Procedure

1. The provider assesses the patient’s spectacles and determines the need for repair or refitting.
2. Measurements of the patient’s anatomical facial characteristics are taken to ensure proper fit.
3. The provider writes laboratory specifications based on the measurements and the patient’s needs.
4. The spectacles are adjusted and refitted to align with the patient’s visual axes and anatomical topography.
5. Final adjustments are made to ensure the spectacles are comfortable and provide optimal vision for the patient.

4. Qualifying circumstances

CPT 92371 is used for patients who have aphakia, which can be due to surgical removal of the lens, a wound, or congenital absence. The repair and refitting of spectacles is necessary to address the specific needs of these patients and ensure proper vision correction. It is important to note that this code should only be used for patients with aphakia, and not for other conditions or general repairs and refittings.

5. When to use CPT code 92371

CPT code 92371 should be used when a patient with aphakia requires repair or refitting of their spectacles. It is important to confirm the patient’s diagnosis of aphakia before using this code. If the patient does not have aphakia, a different code should be used to describe the repair and refitting of their spectacles.

6. Documentation requirements

To support a claim for CPT 92371, the provider must document the following information:

• Patient’s diagnosis of aphakia
• Measurement of anatomical facial characteristics
• Laboratory specifications based on measurements and patient’s needs
• Date and details of the repair and refitting procedure
• Final adjustments made to the spectacles

7. Billing guidelines

When billing for CPT 92371, ensure that the patient has a confirmed diagnosis of aphakia. This code should not be reported if the patient does not have aphakia. It is important to separate the cost of materials from the service of fitting spectacles when reporting this code. Additionally, consider any specific guidelines or requirements from the payer when submitting the claim.

8. Historical information

CPT 92371 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 needs their spectacles repaired and refitted to ensure proper vision correction.
2. A provider adjusts the spectacles of a patient with aphakia to improve comfort and functionality.
3. A patient with aphakia requires a new lens in their spectacles, and the provider performs the necessary repair and refitting.
4. A provider measures the anatomical facial characteristics of a patient with aphakia to ensure the spectacles fit properly.
5. A patient with aphakia visits the provider for regular maintenance and adjustments of their spectacles.
6. A provider writes laboratory specifications for the repair and refitting of spectacles for a patient with aphakia.
7. A patient with aphakia experiences discomfort with their current spectacles, and the provider performs the necessary repairs and adjustments.
8. A provider refits the spectacles of a patient with aphakia to improve the alignment with their visual axes.
9. A patient with aphakia requires a new frame for their spectacles, and the provider performs the necessary repair and refitting.
10. A provider makes final adjustments to the spectacles of a patient with aphakia to ensure optimal vision correction.