Summary & Overview
HCPCS V2311: Trifocal Spherocylinder Intraocular Lens, Per Lens
HCPCS Level II code V2311 denotes a spherocylinder trifocal intraocular lens (IOL) specified by spherical power from +7.25 to +12.00 diopters and cylinder correction from 0.25 to 2.25 diopters, billed per lens. This code is used for recording and billing trifocal IOL implants during cataract extraction or refractive lens exchange procedures. Nationally, accurate coding for advanced multifocal and toric-trifocal lenses affects coverage determinations, patient cost-sharing, and comparison of utilization across payers.
Key payers referenced include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. The publication summarizes typical coverage considerations, coding benchmarks where available, and relevant clinical context for surgeons and facility billing teams. Readers will learn the clinical indication implied by the code, common sites of service, and which payers are commonly involved in coverage decisions. The report also outlines where input data are missing and highlights that specific payer policies, prior authorization requirements, and patient cost responsibilities vary by plan. Data not available in the input are noted where applicable.
Billing Code Overview
HCPCS Level II code V2311 describes a spherocylinder trifocal intraocular lens with spherical power range of +7.25 to +12.00 diopters and cylinder range of 0.25 to 2.25 diopters, billed per lens.
Service Type: Implantable intraocular lens (trifocal), refractive correction
Typical Site of Service: Outpatient ambulatory surgery centers or hospital outpatient departments where cataract or refractive lens exchange procedures are performed
Data not available in the input for associated taxonomies, ICD-10 diagnoses, related codes, and service line.
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with symptomatic presbyopia and significant cataract-related visual decline presents to an ophthalmology clinic for evaluation. After comprehensive preoperative assessment, including manifest refraction, biometry (axial length and keratometry), corneal topography, and discussion of refractive goals, the surgeon selects a trifocal spherocylindrical intraocular lens implanted at the time of cataract extraction to address distance, intermediate, and near vision while correcting astigmatism. The lens ordered falls within the spherical power range of +7.25 to +12.00 diopters and cylinder correction between 0.25 and 2.25 diopters, as described by billing code V2311.
The clinical workflow includes preoperative testing and counseling, surgical insertion of the trifocal toric intraocular lens in the operating suite, immediate postoperative assessment in the recovery area, and routine follow-up visits (postop day 1, week 1, month 1). Pharmacy or optical services may dispense the implanted lens as an item supplied during the surgical encounter or as part of an implant supply charge. Typical site of service is an ambulatory surgery center or hospital outpatient operating room; lens selection and fitting occur in the ophthalmology clinic.
Coding Specifications
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