CPT Code 92392

CPT code 92392 is used for billing the supply of low vision aids.

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What is CPT Code 92392

CPT code 92392 is designated for the supply of low vision aids, excluding spectacles and contact lenses. This code is used by healthcare providers to bill for the provision of devices designed to assist patients with visual impairments in performing daily activities. These aids can include a variety of tools such as magnifiers, electronic devices, or specialized glasses that are not primarily corrective in nature.

Does CPT 92392 Need a Modifier?

For CPT code 92392, which pertains to the supply of low vision aids, the application 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) and -RT (Right Side): These modifiers are used to specify if the low vision aid supplied is for the left or right eye, respectively. This is crucial when the aids are side-specific.

2. -NU (New Equipment): This modifier indicates that the item supplied is new equipment. It's used to differentiate from used or rented equipment, which can affect reimbursement.

3. -RR (Rental): If the low vision aid is provided as a rental rather than a purchase, this modifier should be used. It helps in specifying the billing for rental equipment.

4. -GA (Waiver of Liability Statement Issued): This modifier is used when a waiver of liability statement has been issued as the provider believes Medicare may deny the payment. It is crucial for informing the payer that the patient has been informed and agrees to be financially responsible if the claim is denied.

5. -GX (Notice of Liability Issued, Voluntary Under Payer Policy): Similar to -GA, but used specifically under payer policies where the notice of liability is issued voluntarily.

6. -GY (Item or Service Statutorily Excluded): This modifier is used when the item or service provided is not covered by Medicare because it is considered either unnecessary or not medically necessary.

7. -GZ (Item or Service Expected to be Denied as Not Reasonable and Necessary): Applied when the provider expects that the service or item will be denied as not reasonable and necessary under Medicare.

Each of these modifiers serves a specific purpose in clarifying the circumstances under which the low vision aids are supplied, which is critical for accurate billing and reimbursement. Always check with specific payer guidelines as modifier requirements can vary.

CPT Code 92392 Medicare Reimbursement

CPT code 92392, which pertains to the supply of low vision aids, is not typically reimbursed by Medicare. Medicare generally does not cover low vision aids under the premise that these items are considered "self-help" or "convenience" items, rather than medical necessities. Therefore, patients are usually responsible for the full cost of these aids. It's important for healthcare providers to communicate this to patients to manage their expectations and financial planning.

Are You Being Underpaid for 92392 CPT Code?

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