CPT Code 92391

CPT code 92391 is a billing code used for the supply of contact lenses in healthcare.

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What is CPT Code 92391

CPT code 92391 is designated for the supply of contact lenses. This code is used by healthcare providers when billing for the provision of contact lenses to a patient. It covers the actual physical product and does not include the services related to fitting or follow-up care.

Does CPT 92391 Need a Modifier?

For the CPT code 92391, which is associated with the supply of contact lenses, the use of modifiers can be essential depending on the specific billing circumstances and payer requirements. Here is an ordered list of common modifiers that might be applicable:

1. -LT (Left Side) - Used to specify that the service or item provided, such as contact lenses, is for the left eye.

2. -RT (Right Side) - Used to specify that the service or item provided is for the right eye.

3. -TC (Technical Component) - This modifier could be used if only the technical component of the service (like the fitting of the contact lenses) is being billed, and not the professional component.

4. -26 (Professional Component) - Used when only the professional component of the service is being billed, such as the examination and prescription, but not the actual supply of the lenses.

5. -99 (Multiple Modifiers) - Used when multiple modifiers are necessary to fully explain one service.

Each of these modifiers serves to provide additional clarity to the payer about the specifics of the service provided, ensuring accurate processing and reimbursement. It's important to verify with individual insurance payers as they may have specific guidelines or additional requirements regarding the use of these modifiers for the billing of contact lenses.

CPT Code 92391 Medicare Reimbursement

CPT code 92391, which pertains to the supply of contact lenses, is generally not reimbursed by Medicare. Medicare typically does not cover routine vision services, including the provision of contact lenses or eyeglasses (except post-cataract surgery). There are exceptions where Medicare may cover contact lenses or eyeglasses, but these are usually linked to specific medical conditions or procedures, such as after cataract surgery that implants an intraocular lens.

Since 92391 is associated with the routine supply of contact lenses, it falls outside the scope of Medicare coverage under normal circumstances. Therefore, there is no reimbursement amount listed for this CPT code under Medicare. Providers should inform patients that they will likely be responsible for the full cost of contact lenses supplied under this code.

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