Summary & Overview
HCPCS V2786: Specialty Occupational Multifocal Lens, Per Lens
HCPCS Level II code V2786 designates a specialty occupational multifocal lens billed per lens. Specialty occupational multifocal lenses are designed to support specific visual demands in the workplace by providing multiple focal zones tailored to occupational tasks. Nationally, accurate coding for devices such as these affects coverage determinations, benefit design for vision supplies, and appropriate tracking of vision-related durable medical equipment claims.
Key payers addressed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Coverage policies and reimbursement arrangements for vision supplies vary across these payers, with distinctions in medical necessity criteria, prior authorization requirements, and benefit classification (medical benefit versus vision benefit).
Readers will find a concise reference to the clinical purpose of V2786, typical service settings where these lenses are provided, and which major payers commonly adjudicate claims for occupational specialty lenses. The publication outlines benchmarks and policy considerations relevant to billing and coverage, highlights common modifiers used with similar supply codes, and provides context for integration with vision benefit structures. Data not provided in the input (such as associated taxonomies, ICD-10 diagnoses, or payer-specific rates) is noted as unavailable.
Billing Code Overview
HCPCS Level II code V2786 describes a specialty occupational multifocal lens, per lens. This code represents supply of a multifocal ophthalmic lens designed for occupational use, typically intended to provide varied focal zones for tasks performed in specific work environments.
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Service type: Durable medical supply / vision correction lens
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Typical site of service: Optical retail or vision services setting, outpatient clinics, or facilities where corrective lenses are dispensed and fitted
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A 68-year-old patient with presbyopia and early cataract elects implantation of specialty occupational multifocal intraocular lenses to reduce dependence on reading glasses and improve functional vision at multiple distances. The ophthalmologist performs biometry and preoperative counseling in the clinic, documents ocular history (including prior ocular surgery or corneal irregularities), obtains informed consent, and orders the custom multifocal lenses. On the day of cataract extraction or refractive lens exchange in an ambulatory surgical center, the surgeon implants one or two V2786 specialty occupational multifocal lenses (one per eye as applicable). Postoperative visits occur in the clinic at day 1, week 1, and month 1 to assess visual acuity, refraction, intraocular pressure, and wound healing. The clinical workflow includes device ordering and inventory management, device-level billing using V2786 per lens, procedure documentation referencing the implanted lens model and serial number, and coordination with the patient’s payer for any coverage determinations or patient cost-sharing for a specialty lens.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
00 | No modifier | Standard reporting when no modifier applies |