Summary & Overview
HCPCS V2112: High-Prescription Spherocylinder Single-Vision Lens
HCPCS Level II code V2112 identifies a high-prescription spherocylinder single-vision lens (sphere +/-7.25 to +/-12.00 D; cylinder 2.25 to 4.00 D), billed per lens. This code is used in vision benefit and medical billing when lenses with high refractive powers are dispensed to correct significant myopia, hyperopia, and astigmatism. Nationally, V2112 matters because high-prescription lenses incur higher material and fabrication costs and can affect coverage determinations across commercial and public payers.
Key payers referenced in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of payer coverage considerations, common modifiers used with vision supply claims, and the clinical context for prescribing high-prescription single-vision lenses. The publication summarizes billing best practices, coding clarity for lens-specific supplies, and how this code fits into vision service lines such as eye care retail and clinical ophthalmology/optometry settings.
Data not provided in the input for associated taxonomies, ICD-10 diagnoses, related codes, or payer-specific reimbursement rates is noted as unavailable; the report focuses on the code definition, service context, and payer coverage landscape at a national level.
Billing Code Overview
HCPCS Level II code V2112 describes a spherocylinder single-vision lens with spherical power from +/-7.25 to +/-12.00 diopters and cylindrical power from 2.25 to 4.00 diopters, billed per lens.
Service type: Prescription single-vision corrective lens fabrication and dispensing.
Typical site of service: Optical shops, ophthalmology clinics, optometry offices, and retail vision centers.
Clinical & Coding Specifications
Clinical Context
A 28-year-old patient presents to an optometry or ophthalmology practice for a comprehensive eye examination with complaints of blurred distance vision and asthenopia. Manifest and cycloplegic refraction identify a high refractive error requiring spherocylindrical single-vision spectacle lenses: spherical power in the range of ±7.25 to ±12.00 diopters with cylinder between 2.25 and 4.00 diopters per lens. The clinical workflow includes history and visual acuity assessment, objective refraction (autorefractor and retinoscopy), subjective refraction, slit-lamp anterior segment exam, and prescription documentation. The order for dispensing single-vision spectacle lenses is generated; the optical laboratory receives lens specifications and performs lens surfacing, cylindrical power incorporation and edging for frame fitting. Typical sites of service are outpatient ophthalmology or optometry offices, optical dispensaries within eye clinics, and independent optical laboratories. Common scenarios include high myopia or hyperopia with clinically significant astigmatism requiring custom single-vision spherocylindrical lenses.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
11 | Primary procedure | When this lens order is the primary service of the visit |
22 |