Summary & Overview
CPT 92358: Temporary Intraocular Lens Implantation for Aphakia
CPT code 92358 represents the surgical implantation of a temporary intraocular lens for patients with aphakia to restore vision temporarily or as an interim measure. This code captures a specific ophthalmic surgical service distinct from permanent lens implantation and is relevant for billing clarity and coverage determinations across national payers. The code matters because appropriate coding affects claim adjudication, benefit design interpretation, and access to timely vision-restoring procedures.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise briefing on clinical context and service setting, an outline of common billing modifiers and coding considerations, and what to expect in payer coverage approaches. The publication highlights benchmarking and policy considerations important for providers, billing staff, and payers, including where to look for coverage restrictions, prior authorization triggers, and distinctions between temporary versus permanent lens procedures.
The content provides actionable insights for revenue cycle teams and clinical administrators seeking clarity on classification, typical sites of service, and payer engagement for this ophthalmic procedure. Data not available in the input is noted where applicable.
Billing Code Overview
CPT code 92358 describes the implantation of a temporary intraocular lens to restore vision in a patient with aphakia (absence of the eye's natural lens). This procedure involves placing a removable or short-term lens device within the eye to provide optical correction while a permanent solution is planned or when permanency is not immediately feasible.
Service type: Surgical ophthalmic procedure — temporary intraocular lens implantation
Typical site of service: Hospital operating room or ambulatory surgical center (ophthalmic surgery setting)
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with a history of complicated cataract surgery presents with monocular aphakia and decreased visual acuity uncorrectable with contact lenses or spectacles. The ophthalmic surgeon evaluates the eye, confirms adequate capsular or sulcus support (or documents insufficient support for alternative fixation), and plans implantation of a temporary intraocular lens to restore vision while assessing for a definitive secondary intraocular lens (IOL) solution. Preoperative workflow includes ocular measurements, informed consent, anesthesia evaluation (topical, local block, or monitored anesthesia care), and discussion of risks such as infection, inflammation, and IOL dislocation. On the day of service the provider performs sterile preparation, paracentesis, implantation of the temporary lens into the anterior chamber or sulcus, intraoperative assessment of position and stability, and postoperative medications and instructions. Typical follow-up visits occur within 24–72 hours and at subsequent intervals to monitor vision, intraocular pressure, and inflammation, with plans for lens exchange or permanent IOL implantation when appropriate.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | (Not a standard CMS modifier; report system default) | Data not typically used in claims; follow payer instructions |