Summary & Overview
HCPCS V2306: Spherocylinder Trifocal Lens, High Cylinder
HCPCS Level II code V2306 designates a spherocylinder trifocal lens (per lens) with spherical power from plano to ±4.00 diopters and cylinder power over 6.00 diopters. This code is used when supplying a specialized multifocal ophthalmic lens designed to correct significant astigmatism in addition to distance and near vision needs. Nationally, accurate coding of complex ophthalmic lenses affects claims adjudication, patient cost-sharing, and coverage determinations for vision-related durable medical equipment and supplies.
Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of what the code represents, the typical clinical and supply setting for the service, and what to expect from payer coverage patterns and billing considerations. The publication outlines benchmarks where available, notes common modifiers and billing considerations supplied in the input, and summarizes the clinical context for use of a trifocal spherocylinder lens—particularly for patients with high astigmatism requiring multifocal correction.
Where specific payer policies, taxonomies, or diagnosis mappings are not provided in the input, the report notes that those details were not available and highlights the sections where readers can expect policy and reimbursement guidance when such data are present.
Billing Code Overview
HCPCS Level II code V2306 describes a spherocylinder trifocal lens with a spherical power range of plano to ±4.00 diopters and a cylinder greater than 6.00 diopters, billed per lens. This code captures the provision of a specialized multifocal ophthalmic lens that corrects both spherical and high cylindrical (astigmatic) refractive errors with a trifocal optical design.
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Service type: Ophthalmic lens fitting and supply for vision correction using a trifocal spherocylinder lens.
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Typical site of service: Optical dispensary, ophthalmology clinic, or durable medical equipment/vision supply setting where lenses are manufactured, fitted, and dispensed.
Data not available in the input for payers beyond the generic list provided, associated taxonomies, ICD-10 diagnoses, related codes, and service line.
Clinical & Coding Specifications
Clinical Context
A patient with complex refractive error presents to an ophthalmology clinic for prescription of specialty contact lenses. Typical patient is an adult with high astigmatism (>6.00 diopter cylinder) and a need for trifocal correction across distance, intermediate, and near vision, with spherical power within plano to ±4.00 diopters. The workflow: evaluation by an ophthalmologist or optometrist includes history, manifest and cycloplegic refraction, slit-lamp exam, corneal topography, and measurement of contact lens fit. Trial lenses or custom lens ordering occurs, with measurements documented and the HCPCS Level II code V2306 billed per lens when a spherocylinder trifocal lens meeting the specified power ranges is dispensed. Follow-up visits assess fit, visual acuity at multiple distances, and corneal health; adjustments or replacements are documented and billed as appropriate. Typical sites of service are outpatient ophthalmology clinics, specialty contact lens centers, or ambulatory surgical centers when dispensed as part of post‑operative care. Common patient scenarios include post‑cataract surgery patients with residual astigmatism requiring trifocal contact lens correction, patients with keratoconus or post‑keratoplasty irregular astigmatism managed with specialty trifocal contact lenses, or presbyopic patients requiring multifocal correction with high astigmatic correction needs.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component |