Summary & Overview
HCPCS V2512: Contact Lens, Gas Permeable Bifocal, Per Lens
HCPCS Level II code V2512 represents a single gas permeable bifocal contact lens supplied to correct both near and distance vision. Lens supplies for complex visual needs are important nationally as they affect outpatient vision care access, medical device coding, and payer coverage policies for refractive aids. The code is used in billing the provision of a rigid gas permeable bifocal lens when supplied to a patient.
Key payers in scope include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for RGP bifocal lenses, typical sites of service where this supply occurs, and the payer landscape relevant to coverage and billing. The publication includes benchmarks where available, common modifiers listed in claims environments, and notes on documentation and coding practice. Policy updates that affect coverage determinations and coding guidance for vision supplies are summarized for national audiences.
This resource is intended to clarify what V2512 denotes in clinical and billing terms, outline the payers commonly involved, and point readers to areas where additional payer-specific coverage details or local medical policy review may be required.
Billing Code Overview
HCPCS Level II code V2512 describes a contact lens, gas permeable, bifocal, per lens. This code represents the supply of a single rigid gas permeable (RGP) bifocal contact lens designed to provide two distinct optical powers for near and distance vision in one lens.
Service type: Durable medical supply / vision corrective device
Typical site of service: Ophthalmology or optometry clinics, optical dispensaries, and retail vision centers
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 62-year-old patient with presbyopia and keratoconus presents to an ophthalmology or optometry clinic for visual rehabilitation. The provider performs a comprehensive eye examination including refraction, corneal topography, and slit-lamp evaluation to determine suitability for specialty contact lenses. The patient is fitted for a gas-permeable bifocal contact lens (V2512) to correct both distance and near vision while accommodating corneal irregularity. The clinical workflow includes initial assessment, diagnostic fitting with trial lenses, measurement of fit and visual acuity, ordering of custom lenses, and subsequent follow-up visits for final fit verification and adjustments. Typical sites of service are outpatient ophthalmology clinics, optometry offices, and specialty contact lens fitting centers. Common clinical staff involved include the optometrist or ophthalmologist, licensed fitters, and optical technicians. Billing uses V2512 per lens when custom gas-permeable bifocal lenses are dispensed; professional services such as fitting and evaluation are billed separately under applicable CPT codes or physician services with appropriate modifiers as needed.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
LT | Left side | Added when billing for the left eye lens |