Summary & Overview
HCPCS V2315: Lenticular (Myodisc) Trifocal Lens, Per Lens
HCPCS Level II code V2315 denotes a lenticular (myodisc) trifocal intraocular lens billed per lens. This code is used to report provision of trifocal lenses intended to provide multiple focal points for patients undergoing cataract or refractive lens procedures. It matters nationally because intraocular lens selection and billing affect coverage decisions, patient out-of-pocket costs, and claims processing consistency across payers.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for trifocal lenticular lenses, common billing and site-of-service considerations, and the typical payer landscape governing coverage. The publication summarizes benchmark billing practices, common modifiers used in claims, and areas where policy updates or payer guidance often influence reimbursement and authorization requirements.
This summary equips clinicians, billing staff, and policy analysts with concise information on what V2315 represents, where it is typically used, and which major payers commonly manage claims for this device. Data not available in the input will be noted in specific sections of the full publication.
Billing Code Overview
HCPCS Level II code V2315 describes a lenticular (myodisc) trifocal lens billed per lens. This code applies to the provision of a trifocal intraocular lens designed to correct vision at multiple focal points using a lenticular or myodisc optical design.
-
Service type: Durable medical device / prosthetic intraocular lens implantation accessory (lens provision)
-
Typical site of service: Ophthalmology clinic, ambulatory surgery center, or hospital outpatient setting
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with presbyopia and symptomatic cataracts presents to an ophthalmology clinic for evaluation. The surgeon recommends implantation of a lenticular trifocal myodisc intraocular lens to restore distance, intermediate, and near vision during cataract extraction. The clinical workflow includes preoperative evaluation (visual acuity, refraction, ocular biometry including axial length and keratometry, ocular surface optimization), informed consent discussing multifocal optics and potential visual phenomena, scheduling the cataract extraction with intraocular lens implantation, intraoperative cataract removal (phacoemulsification) with implantation of the V2315 lenticular (myodisc) trifocal lens per eye, and postoperative visits for refractive assessment and management of any dysphotopsias or residual refractive error. Typical site of service is an ambulatory surgery center or hospital outpatient surgical unit where intraocular lens devices are implanted under sterile operative conditions.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the surgeon/physician professional work separate from facility/device charges. |
52 |