V2199 Single Vision Lens HCPCS Reimbursement | OpenPayer

Summary & Overview

HCPCS V2199: Single Vision Lens, Not Otherwise Classified

HCPCS Level II code V2199 denotes a single-vision ophthalmic lens classified as “not otherwise classified.” Nationally, this code matters for vision benefit management and claims processing when a supplied lens does not match a more specific HCPCS lens code. Insurers rely on a clear designation for single-vision lenses to route claims, determine coverage under eyewear benefits, and adjudicate payment for vision supplies.

Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of what V2199 represents, the typical clinical and service context for use, and what payers commonly consider when processing such lens claims. The publication outlines expected benchmarks and billing considerations, summarizes common modifiers associated with vision supply claims, and provides clinical context for single-vision lenses versus other lens types.

This summary is intended for billing managers, practice administrators, and policy analysts who need a clear, national-level reference for coding and claim categorization of single-vision lenses that lack a specific HCPCS match.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicareV2199HCPCS Level IIsingle vision lensophthalmic lensvision suppliesoptical dispensingmedical billingclaims coding

Billing Code Overview

HCPCS Level II code V2199 is described as Not otherwise classified, single vision lens. This code is used for billing single-vision ophthalmic lenses that do not fit a more specific HCPCS Level II lens code. The service type is single vision corrective lens provision, and the typical site of service is optical dispensing locations, vision clinics, and ophthalmology/optometry offices where lenses are measured, fitted, and provided to patients.

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Clinical & Coding Specifications

Clinical Context

A patient presents to an optometry or ophthalmology clinic requesting single-vision corrective lenses after a comprehensive eye examination. Typical patients include adults or children with refractive error such as myopia, hyperopia, or simple astigmatism requiring a single focal power across the lens. The clinical workflow begins with a refraction and visual acuity assessment, ocular health exam, and documentation of the prescription. The provider documents the medical necessity for single-vision lenses when related to a refractive diagnosis. The optical dispenser or in-house lab receives the prescription and orders fabrication of a single-vision lens encoded by billing code V2199 when the lens does not fit any specific HCPCS-listed lens category. The service may be billed to commercial payors (Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, BUCA) or Medicare when applicable, using appropriate modifiers for special circumstances (for example increased procedural complexity or split/shared services). Typical site of service is an outpatient clinic, optical dispensary within a physician practice, or an ambulatory surgery center if combined with a surgical procedure requiring intraoperative lens replacement. Documentation includes the eyeglass prescription, lens specifications, medical record with refractive findings, and any supporting medical necessity notes for payor review.

Coding Specifications

Modifier	Description	When to Use
`22`

HCPCS V2103: Spherocylinder Single-Vision Lens, Per Lens

HCPCS-V2786-SPECIALTY-OCCUPATIONAL-MULTIFOCAL-LENS

HCPCS V2786: Specialty Occupational Multifocal Lens, Per Lens

HCPCS-V2218-ANISEIKONIC-BIFOCAL-LENS

HCPCS Level II V2218: Aniseikonic Bifocal Lens

HCPCS-V2302-TRIFOCAL-SPHERE-INTRAOCULAR-LENS

HCPCS V2302: Trifocal Spherical Intraocular Lens, Per Lens

HCPCS-V2314-SPHEROCYLINDER-TRIFOCAL-LENS-HIGH-SPHERE

HCPCS V2314: Spherocylinder Trifocal Lens, High-Sphere

HCPCS-V2219-BIFOCAL-SEGMENT-WIDTH-OVER-28MM

HCPCS V2219: Bifocal Segment Width Over 28 mm

HCPCS-V2311-TRIFOCAL-SPHEROCYLINDER-INTRAOCULAR-LENS

HCPCS V2311: Trifocal Spherocylinder Intraocular Lens, Per Lens

HCPCS-V2502-PMMA-BIFOCAL-CONTACT-LENS-PER-LENS

HCPCS V2502: PMMA Bifocal Contact Lens, Per Lens

HCPCS-V2510-GAS-PERMEABLE-SPHERICAL-CONTACT-LENS

HCPCS V2510: Contact Lens, Gas Permeable, Spherical, Per Lens

HCPCS-V2610-SINGLE-LENS-SPECTACLE-MOUNTED-LOW-VISION-AID

HCPCS V2610: Single Lens Spectacle Mounted Low Vision Aid

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Taxonomy Code	Specialty	Notes
`207P00000X`	Ophthalmology	Eye care physicians who diagnose refractive errors and prescribe corrective lenses.
`152W00000X`	Optometry	Optometrists performing refraction and prescribing single-vision lenses.
`174400000X`	Optician	Dispensing professionals who fabricate and fit eyeglass lenses.
`163WL0500X`	Ophthalmic Plastic and Reconstructive Surgery	Specialists who may order corrective lenses in periocular surgical care.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`H52.13`	Myopia, bilateral	Common refractive indication for single-vision corrective lenses.
`H52.03`	Hypermetropia, bilateral	Hyperopia treated with single-vision distance or near lenses.
`H52.223`	Astigmatism, bilateral, regular	Astigmatic refractive error that may be corrected with single-vision toric lenses.
`H52.4`	Presbyopia	Near-vision refractive need commonly managed with single-vision near lenses or separate reading glasses.
`H52.9`	Unspecified disorder of refraction	Used when a specific refractive diagnosis is not otherwise specified but single-vision lenses are indicated.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`92004`	Comprehensive ophthalmological evaluation, new patient, with initiation of diagnostic and treatment program	Performed prior to prescription of single-vision lenses for a new patient to evaluate ocular health and refractive status.
`92014`	Comprehensive ophthalmological evaluation, established patient, with initiation of diagnostic and treatment program	Routine follow-up exam that can result in an updated single-vision prescription billed with `V2199` for the lens supply.
`92015`	Determination of refractive state	Alternative/refraction code (often `92015` is bundled in other eye exams) used to document refraction that supports lens prescription.
`92310`	Prescription of optical and physical characteristics for spectacles, by a physician or other qualified health care professional	Used to document and bill professional services associated with prescribing single-vision lenses prior to dispensing.
`99070`	Supply and material (except spectacles), provided by the physician over and above those usually included with the office visit	May be used for additional nonstandard supplies associated with lens delivery when applicable.

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