Summary & Overview
HCPCS Level II V2631: Iris Supported Intraocular Lens
HCPCS Level II code V2631 denotes an iris supported intraocular lens, an ophthalmic implant used when standard capsular fixation is not feasible. This code matters nationally because it identifies a specialized device category with distinct surgical implications and payment considerations across public and commercial payers. Proper coding impacts device reimbursement, device reporting, and procedural billing clarity for surgeons and facilities.
Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the device and clinical context, an outline of typical sites of service, and the scope of common modifiers associated with device and procedural billing. The publication summarizes what providers and billing teams need to know about claims classification and administrative handling of this implant code.
This summary also highlights the topics addressed in the full publication: national benchmarks where available, payer coverage patterns, coding nuances related to device versus procedure reporting, and relevant policy or coverage update considerations. Data gaps in the input are identified where present. The focus is national in scope and intended for clinicians, coding professionals, and revenue cycle staff seeking clarity on billing and administrative treatment of an iris supported intraocular lens under HCPCS Level II code V2631.
Billing Code Overview
HCPCS Level II code V2631 describes an iris supported intraocular lens, a specialty ophthalmic implant designed to be anchored to the iris to replace or supplement the eye's natural lens. This device is used in surgical procedures addressing lens replacement when standard capsular support is inadequate or when specific iris fixation is clinically indicated.
Service Type
- Ophthalmic implant procedure
Typical Site of Service
- Hospital operating room
- Ambulatory surgical center (ASC)
- Ophthalmic specialty surgical suite
Clinical & Coding Specifications
Clinical Context
A typical patient is a 65-year-old with complicated cataract surgery history or traumatic iris loss who requires an iris-supported intraocular lens (V2631) to restore vision and anterior segment anatomy. The workflow begins with an ophthalmology clinic visit where best-corrected visual acuity, slit-lamp exam, and biometry identify inadequate capsular support or significant iris defect. Preoperative counseling and medical clearance are completed, and informed consent documents the use of a specialty intraocular lens.
On the day of service, the patient undergoes regional or monitored anesthesia care in an outpatient ambulatory surgery center or hospital operating room. The surgeon performs anterior segment preparation, iris fixation or enclavation as indicated, and implants the iris-supported intraocular lens. Intraoperative documentation includes lens model, laterality, fixation method, any concurrent anterior vitrectomy, and estimated blood loss if applicable. Postoperative care includes same-day brief exam, topical antibiotics and steroids, and scheduled follow-ups to monitor intraocular pressure, wound integrity, and visual rehabilitation.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Use when no modifier applies to the service. |