Summary & Overview
HCPCS V2219: Bifocal Segment Width Over 28 mm
HCPCS Level II code V2219 identifies bifocal lenses with a segment width greater than 28 mm, a specification used in billing for optical products and durable medical equipment related to vision correction. Nationally, this code matters for accurate claims capture of lens characteristics that can affect coverage determinations and product categorization across commercial and government payers.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise review of billing context for V2219, including common reimbursement considerations, where this product-level code fits in the eyewear service line, and implications for claim documentation.
The publication provides practical benchmarks and policy context relevant to payers and billing teams: expected sites of service, typical clinical scenarios for bifocal prescriptions, and how this code interacts with broader optical billing practices. Data elements not provided in the source are identified as unavailable. The goal is to give billing managers, coders, and policy analysts a clear, national-level reference for HCPCS Level II code V2219 and its role in optical product billing.
Billing Code Overview
HCPCS Level II code V2219 denotes bifocal segment width over 28 mm for eyewear lenses. This code captures a specific optical lens characteristic used when billing for bifocal lenses that have a segment width greater than 28 millimeters.
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Service type: Eyewear lens product specification
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Typical site of service: Optical shop, retail eyeglass provider, or outpatient eye care facility
Clinical & Coding Specifications
Clinical Context
A patient presents to an ophthalmic optical dispensary or an ophthalmology/optometry clinic requesting bifocal eyeglasses. The patient has a refractive needs assessment showing presbyopia with a required bifocal segment width greater than 28 mm to accommodate a wide near-vision corridor or occupational visual demands. The typical workflow includes: a refraction and binocular visual assessment by an optometrist or ophthalmologist, measurements for spectacle fitting (including segment height and desired segment width), lens design selection and verification that a bifocal segment >28 mm is required, generation of an order to an optical laboratory, and dispensing with a final fit check. Services are performed in an outpatient eye clinic, optical shop within a medical office, or an independent optical laboratory setting. The patient scenario commonly involves adults with presbyopia, anisometropia, or occupational tasks (e.g., craftsmen, drivers) necessitating a large near segment for expanded reading field and reduced image jump.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | When lenses or frames are billed separately for the left eye |
RT | Right side |