Summary & Overview
HCPCS V2309: Trifocal Spherocylinder Intraocular Lens, Per Lens
HCPCS Level II code V2309 denotes a spherocylinder trifocal intraocular lens with spherical power between +4.25 and +7.00 diopters and cylinder power between 4.25 and 6.00 diopters, billed per lens. This category of implantable ophthalmic device is used in cataract surgery or refractive lens exchange to correct high degrees of myopia or hyperopia combined with significant astigmatism while providing trifocal vision correction. Nationally, codes for specialized intraocular lenses matter because they affect device coverage, patient out-of-pocket costs, and hospital and ASC billing practices.
Key payers commonly involved in coverage and reimbursement considerations include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context and procedural settings, typical payer coverage considerations, common modifiers, and related billing elements. The publication outlines benchmark topics such as coding intent, sites of service where the device is supplied and billed, and factors that influence payer adjudication for advanced intraocular lenses. Additionally, the piece highlights where input data are available and where specific payer policy details or ICD-10 pairings are not provided in the input. This summary equips billing managers, ophthalmic surgeons, and revenue cycle staff with the essential coding description and the national context needed to locate payer policies and integrate the code into procedural charge lines.
Billing Code Overview
HCPCS Level II code V2309 describes a spherocylinder, trifocal intraocular lens with spherical power from +4.25 to +7.00 diopters and cylinder power from 4.25 to 6.00 diopters, billed per lens. The description implies this is an implantable ophthalmic lens designed to correct both spherical and significant astigmatic refractive errors while providing a trifocal optical design for multiple focal distances.
Service Type: Intraocular lens implantation / ophthalmic prosthetic device
Typical Site of Service: Ambulatory surgical center or hospital outpatient surgical suite, where cataract or refractive lens exchange procedures and intraocular lens implantations are performed.
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with progressive presbyopia and cataract-related visual decline presents to an ophthalmology practice for evaluation of intraocular lens (IOL) options during cataract extraction. The surgeon documents a high refractive error with combined spherical and astigmatic components and recommends a trifocal spherocylindrical IOL with a spherical power in the range of +4.25 to +7.00 diopters and a cylindrical correction between 4.25 and 6.00 diopters per lens. The clinical workflow includes a preoperative refractive assessment (manifest and cycloplegic refraction), biometry (axial length and keratometry), discussion of lens options and informed consent, scheduling of phacoemulsification with IOL implantation, and postoperative refraction and visual outcome assessment. The product described by V2309 is used when a multifocal trifocal spherocylinder lens with the specified sphere and cylinder powers is implanted to correct significant hyperopia and high astigmatism while providing near, intermediate, and distance vision. Typical site of service is an ambulatory surgery center or hospital outpatient surgical department where cataract extraction with IOL implantation is performed. Typical patient scenario: an elderly patient with visually significant cataract, high hyperopic spherical equivalent and clinically significant regular corneal astigmatism who elects implantation of a premium trifocal toric IOL to reduce spectacle dependence.
Coding Specifications
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