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CPT 92312: Contact Lens Prescription and Fitting for Aphakia
CPT code 92312 covers the complete contact lens prescription and fitting for both eyes in patients who are aphakic after cataract extraction. This code captures a specialty ocular service that addresses the unique refractive rehabilitation needs of patients without a natural lens and can have implications for clinical workflows, device supply, and payer coverage policies nationwide. Key payers relevant to national reimbursement environments include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise explanation of the clinical indication and service components represented by the code, typical sites of care, and the payer landscape. The publication summarizes commonly used billing modifiers and highlights what to expect in claims processing and reimbursement considerations. It also provides benchmarking context and identifies policy or coverage features that commonly affect authorization and payment for post‑cataract contact lens services. Data not available in the input will be noted where applicable.
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Billing Code Overview
CPT code 92312 describes a comprehensive contact lens prescription and fitting for both eyes performed when the patient is aphakic following prior cataract surgery. The service includes all components of evaluation and fitting needed to determine and dispense corrective contact lenses for patients who lack the natural lens of the eye.
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Service type: Contact lens prescription and fitting
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Typical site of service: Ophthalmology or optometry clinic, specialty contact lens fitting setting