Summary & Overview
HCPCS V2310: Trifocal Spherocylinder Lens for High Sphere and Astigmatism
HCPCS Level II code V2310 denotes a specialized trifocal spherocylinder ophthalmic lens for patients with high spherical power (+/- 4.25 to +/- 7.00 D) combined with significant astigmatism (greater than 6.00 D), billed per lens. This code captures a clinically distinctive optical appliance used to correct complex refractive errors while providing multifocal vision correction, making it relevant for vision services, durable medical equipment billing, and specialty optical suppliers. Nationally, accurate coding of such high-power, high-cylinder trifocal lenses affects claims processing, coverage determination, and patient access to advanced corrective devices.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical purpose and service setting for V2310, common modifiers associated with vision and supply claims (listed separately), and guidance on typical billing contexts. The publication highlights benchmarks for coverage policies, coding considerations for specialty lenses, and the clinical circumstances that commonly lead to use of this code. Data not available in the input is clearly noted where applicable, and the content is structured to support billing staff, payers, and clinicians involved in specialty ophthalmic device procurement and reimbursement.
Billing Code Overview
HCPCS Level II code V2310 describes a spherocylinder, trifocal ophthalmic lens with spherical power ranging from +4.25 to +7.00 diopters (or minus equivalent) and a cylinder greater than 6.00 diopters, billed per lens. This lens is a specialized corrective optical device designed to address both high spherical refractive error and significant astigmatism while providing trifocal visual zones for distance, intermediate, and near vision.
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Service type: Prescription, fabrication, and supply of a specialty ophthalmic corrective lens (trifocal spherocylinder lens).
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Typical site of service: Optical dispensary, ophthalmology or optometry clinic, or outpatient specialty vision care setting.
Clinical & Coding Specifications
Clinical Context
A 72-year-old patient with advanced presbyopia and visually significant cataracts presents for cataract extraction with intraocular lens (IOL) implantation. The surgeon selects a specialized spherocylinder, trifocal IOL with a spherical power between +4.25 and +7.00 diopters and greater than 6.00 diopters of cylinder correction to address high hyperopia combined with substantial corneal astigmatism and a desire for reduced spectacle dependence. The typical workflow includes preoperative biometric measurements (axial length, keratometry, corneal topography), discussion of lens options and informed consent, cataract extraction (phacoemulsification), and implantation of the specified trifocal toric IOL. Postoperative visits include day-one, one-week, and one-month assessments for visual acuity, refractive status, intraocular pressure, and wound healing. Ancillary services can include optical biometry, corneal topography, and possible intraoperative aberrometry when available. The typical site of service is an ambulatory surgical center or hospital outpatient department where ophthalmic surgical procedures and IOL implantation are performed. Patient modifiers may reflect laterality (RT/LT), bilateral procedures, medical complications, or facility versus professional components of services.
Coding Specifications
| Modifier | Description | When to Use |
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