CPT® Code 92312

Official Description

Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation; corneal lens for aphakia, both eyes

Common Language Description

The CPT® Code 92312 refers to the prescription and fitting of contact lenses specifically designed for patients with aphakia in both eyes. Aphakia is a condition characterized by the absence of the eye's natural lens, often resulting from cataract surgery or congenital issues. In this procedure, the medical provider evaluates the patient's vision requirements and selects the most suitable contact lens options tailored to their specific needs. The provider engages in a detailed discussion with the patient regarding the various types of contact lenses available, highlighting the advantages and disadvantages of each option. This collaborative approach ensures that the patient is well-informed and can make an educated choice regarding their vision correction. The provider specifies essential optical and physical characteristics of the chosen lenses, which may include parameters such as power (the lens strength), size, curvature, flexibility (whether the lens is hard or soft), and gas-permeability. These characteristics are crucial for achieving optimal visual acuity and comfort. During the fitting process, the provider inserts the lenses and assesses their fit, making necessary adjustments to ensure that the lenses provide the best possible vision correction and comfort for the patient. Additionally, the patient receives instructions on how to properly insert and remove the lenses, with opportunities to practice under the provider's supervision. To further assist in finding the most suitable lenses, the provider may offer sample contact lenses from various manufacturers for the patient to trial over a specified period. This trial phase allows for incidental revisions to the lenses' optical and physical characteristics, enhancing visual acuity and comfort as needed. All aspects of this procedure are conducted by the medical provider, ensuring comprehensive care and support for the patient throughout the adaptation process.

1. Indications

The procedure associated with CPT® Code 92312 is indicated for patients diagnosed with aphakia in both eyes. This condition may arise due to various reasons, including but not limited to cataract surgery, congenital absence of the lens, or trauma. The primary goal of this procedure is to restore visual function and improve the quality of life for individuals affected by this condition.

Aphakia in both eyes The procedure is specifically designed for patients who have lost their natural lenses in both eyes, necessitating the use of contact lenses for vision correction.

2. Procedure

The procedure for CPT® Code 92312 involves several key steps to ensure the successful fitting and adaptation of contact lenses for patients with bilateral aphakia. Each step is critical to achieving optimal visual outcomes and patient comfort.

Step 1: Patient Evaluation The process begins with a thorough evaluation of the patient's vision needs. The medical provider assesses the patient's visual acuity and discusses their specific requirements and preferences regarding contact lenses.
Step 2: Lens Selection Based on the evaluation, the provider presents various contact lens options, detailing the pros and cons of each type. This discussion helps the patient understand which lenses may best suit their lifestyle and visual needs.
Step 3: Specification of Lens Characteristics Once a lens type is selected, the provider specifies the optical and physical characteristics of the lenses. This includes determining the appropriate power, size, curvature, flexibility (hard or soft), and gas-permeability of the lenses.
Step 4: Lens Insertion and Fit Check The provider then inserts the selected lenses into the patient's eyes and checks the fit. Adjustments are made as necessary to ensure that the lenses provide the best visual acuity and comfort.
Step 5: Patient Instruction After the lenses are fitted, the patient receives detailed instructions on how to properly insert and remove the lenses. The provider guides the patient through practice sessions to ensure they are comfortable with the process.
Step 6: Trial Period The patient may be given sample lenses from different manufacturers to try for a designated period. This allows the patient to assess comfort and visual performance, and any incidental revisions to the lenses' characteristics can be made during this time to enhance the overall experience.

3. Post-Procedure

Post-procedure care involves monitoring the patient's adaptation to the contact lenses. The provider may schedule follow-up appointments to assess the fit and comfort of the lenses, as well as to make any necessary adjustments. Patients are encouraged to report any discomfort or vision issues during the trial period. Proper care and maintenance of the contact lenses are also emphasized, including hygiene practices for insertion and removal. The provider will ensure that the patient understands the importance of regular check-ups to maintain optimal eye health and lens performance.

Short Descr	CONTACT LENS FITG APHAKIA OU
Medium Descr	RX&FITG CONTACT LENS CORNEAL LENS APHAKIA OU
Long Descr	Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation; corneal lens for aphakia, both eyes
Status Code	Active Code
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	0 - Physician Service Code
Multiple Procedures (51)	0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50)	2 - 150% payment adjustment does NOT apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62)	0 - Co-surgeons not permitted for this procedure.
Team Surgery (66)	0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	STV-Packaged Codes
Type of Service (TOS)	Q - Vision Items or Services
Berenson-Eggers TOS (BETOS)	M5C - Specialist - ophthalmology
MUE	1
CCS Clinical Classification	220 - Ophthalmologic and otologic diagnosis and treatment

52	Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
AQ	Physician providing a service in an unlisted health professional shortage area (hpsa)
LT	Left side (used to identify procedures performed on the left side of the body)
RT	Right side (used to identify procedures performed on the right side of the body)