Summary & Overview
HCPCS V2312: Spherocylinder Trifocal Lens, Per Lens
HCPCS Level II code V2312 denotes a spherocylinder trifocal lens (per lens) with a spherical power range of ±7.25 to ±12.00 diopters and cylindrical power of 2.25 to 4.00 diopters. The code captures supply of a specialized ophthalmic lens used to correct significant spherical and astigmatic refractive errors across three focal zones, which matters nationally as advanced corrective lenses intersect clinical outcomes, device coverage policy, and supply reimbursement across payers. Key payers in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will learn what the code represents clinically and operationally, which payers typically adjudicate claims for this device, and where the code fits in service delivery (outpatient ophthalmology, ambulatory surgical centers, and optical dispensing). The publication outlines benchmarks and coverage patterns, summarizes relevant policy considerations for device supply and billing, and provides clinical context on when a trifocal spherocylinder lens would be used. Data not available in the input is noted where applicable.
Billing Code Overview
HCPCS Level II code V2312 describes a spherocylinder trifocal lens specified as plus or minus 7.25 to plus or minus 12.00 diopter sphere with 2.25 to 4.00 diopter cylinder, billed per lens. This code represents the supply of a specialized multifocal ophthalmic lens designed to correct both spherical and cylindrical refractive errors with three focal zones.
Service Type: Ophthalmic prosthetic/device (trifocal contact or intraocular lens)
Typical Site of Service: Outpatient ophthalmology clinic, ambulatory surgical center, or optical dispensing facility
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with progressive presbyopia and coexisting cataract seeks refractive correction to reduce dependence on spectacles. The ophthalmologist evaluates the patient preoperatively in an outpatient ambulatory surgery center and documents biometry, keratometry, manifest refraction showing significant astigmatism and presbyopia, and discusses lens options. The surgeon selects a trifocal spherocylindrical intraocular lens with a sphere power in the range +7.25 to +12.00 diopters and cylinder power between 2.25 and 4.00 diopters, ordered per eye. The service includes device selection, ordering the ophthalmic lens, and implantation during cataract extraction with intraocular lens insertion in the operating room or ambulatory surgical center. Typical workflow steps: preoperative evaluation and measurements; informed consent and lens choice documentation; ordering the specific lens model and supply coding with V2312 per lens; performance of cataract surgery with IOL implantation; postoperative visits for refractive and visual outcome assessment.
Coding Specifications
| Modifier | Description | When to Use |
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