October 10, 2011

 

BC-11-13
ASC-11-11
 
 

To:

All Blue Cross and Blue Shield of Kansas Contracting Providers

From:

Connie Winkley – Education/Communication Coordinator
Institutional Provider Relations
Blue Cross and Blue Shield of Kansas, Inc.
An Independent Licensee of the Blue Cross and Blue Shield Association

Subject:

Intraocular Lens (IOL)

An Intraocular lens, or IOL, is an implanted lens used as a replacement for a clouded lens removed in cataract surgery, or as a correction for a refraction problem.

The following HCPCS codes can be used when billing for the basic IOL:

HCPCS code V2787 (Astigmatism correcting function of intraocular lens) and V2788 (Presbyopia correcting function of intraocular lens) are for the astigmatism and presbyopia function part of the lens, which is considered deluxe and non-covered.  Effective September 1, 2011, Blue Cross and Blue Shield of Kansas will deny any claims billed when either code V2787 or V2788 is used in field locator (FL) 44 on the UB-04 claim form.    

Providers should bill for the basic lens using codes V2630, V2631 or V2632 and then can use either code V2787 or V2788 to bill for the function lens separately.   When billing for the function lens and using code V2787 or V2788, the charges should be put in the non-covered column.  A waiver is not required as the charge is considered non-covered.

BlueCard benefits may be different.  Please check with the member’s home plan to determine coverage for these types of deluxe lens.

To verify member benefits contact customer service at 1-800-432-3990.  If you have questions, please contact your provider rep.

cw