Transcription of EYEMED ACCEPTABLE SERVICE CODES
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EYEMED ACCEPTABLE SERVICE CODES . Effective 10/16/03. Exam & Fit/Follow Up Services ACCEPTABLE Code Modifier 92002 New Intermediate 92004 New Comprehensive 92012 Established Intermediate 92014 Established Comprehensive S0620 Routine Opthalmological - New Patient S0621 Routine Opthalmological - Established Patient 92015 TG VDT Refraction (Valid only on certain plans). 92310 Prescription, fitting & dispensing of contacts by doctor 92314 Prescription, fitting & dispensing of contacts by tech S0592 Comprehensive Contact Lens Evaluation Contact Lens Materials ACCEPTABLE Code Modifier S0500 ALL DISPOSABLE/PLANNED REPLACEMENT CONTACTS. S0512 DAILY WEAR SPECIALTY CONTACTS. V2330 CONTACT LENS, SCLERAL. V2500 PMMA, SPHERICAL. V2501 PMMA TORIC OR PRISM BALLA. V2502 PMMA, BIFOCAL.
Acceptable Code Modifier V2219 Seg.width>28mm (explanation required) V2219 Flat Top 35 V2219 Executive V2220 Add >3.25D V2319 Seg.width>28mm (explanation required) V2319 Flat Top 35 V2319 Executive V2320 Add >3.25D Lens Add On and Material Codes Acceptable Code Modifier V2799 Glass Lenses V2780 Oversize V2760 Scratch Coating
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