CPT® Code 92314

Official Description

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

Common Language Description

The CPT® Code 92314 refers to the prescription of optical and physical characteristics of contact lenses, specifically corneal lenses, for both eyes, excluding cases of aphakia. This procedure involves a comprehensive assessment of the patient's vision needs by a medical provider, who selects the most suitable contact lens options. The provider engages in a detailed discussion with the patient regarding the advantages and disadvantages of various types of contact lenses available in the market. This includes considerations of the lenses' optical and physical characteristics, such as power, size, curvature, flexibility (whether the lens is hard or soft), and gas-permeability. Following the selection process, the provider inserts the chosen lenses and evaluates their fit, making necessary adjustments to ensure optimal visual acuity and comfort for the patient. An independent technician then plays a crucial role in the adaptation process by instructing the patient on how to properly insert and remove the lenses. The technician provides hands-on assistance as the patient practices these techniques. Additionally, patients may be given sample lenses from different manufacturers to trial, allowing them to determine which lenses best meet their individual needs. During this trial period, incidental modifications to the lenses' optical and physical characteristics may be made to enhance visual acuity or comfort, ensuring a tailored approach to the patient's vision correction needs.

1. Indications

The procedure associated with CPT® Code 92314 is indicated for patients requiring vision correction through contact lenses, specifically corneal lenses, for both eyes. The following conditions may warrant this procedure:

Vision Impairment Patients experiencing refractive errors such as myopia (nearsightedness), hyperopia (farsightedness), or astigmatism that can be corrected with contact lenses.
Preference for Contact Lenses Individuals who prefer contact lenses over traditional eyeglasses for aesthetic or lifestyle reasons.
Previous Eyeglass Users Patients transitioning from eyeglasses to contact lenses for improved visual field and convenience.

2. Procedure

The procedure for CPT® Code 92314 involves several key steps to ensure the successful fitting and adaptation of contact lenses:

Step 1: Patient Assessment The medical provider begins by conducting a thorough assessment of the patient's vision needs, including a review of their medical history and current vision status. This assessment helps in determining the appropriate type of contact lenses required.
Step 2: Lens Selection Based on the assessment, the provider discusses various contact lens options with the patient, explaining the pros and cons of each type. The provider specifies the optical and physical characteristics of the selected lenses, such as power, size, curvature, flexibility, and gas-permeability.
Step 3: Lens Insertion and Fit Check After selecting the lenses, the provider inserts them into the patient's eyes. The fit of the lenses is then checked to ensure they provide optimal visual acuity and comfort. Adjustments are made as necessary to achieve the best possible fit.
Step 4: Technician Involvement An independent technician assists the patient by providing instructions on how to properly insert and remove the lenses. The technician observes the patient as they practice these techniques, offering guidance and support as needed.
Step 5: Trial Period Patients may be given sample contact lenses from different manufacturers to try during a designated trial period. This allows the patient to evaluate which lenses best meet their needs. During this time, incidental revisions to the lenses' optical and physical characteristics may be made to enhance visual acuity or comfort.

3. Post-Procedure

Post-procedure care for patients fitted with contact lenses under CPT® Code 92314 includes follow-up appointments to monitor the adaptation process and ensure the lenses are functioning as intended. Patients are advised to report any discomfort, vision changes, or issues with lens insertion and removal. Regular check-ups may be scheduled to assess the fit and condition of the lenses, as well as to make any necessary adjustments. Additionally, patients should receive guidance on proper lens care and hygiene practices to prevent complications such as infections or lens damage.

Short Descr	C-LENS FITG TECH OU
Medium Descr	RX&FITG C-LENS TECH CRNL LENS OU XCPT APHAKIA
Long Descr	Prescription of optical and physical characteristics of contact lens, with medical supervision of adaptation and direction of fitting by independent technician; corneal lens, both eyes except for aphakia
Status Code	Non-Covered Service
Global Days	XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC)	9 - Not Applicable
Multiple Procedures (51)	9 - Concept does not apply.
Bilateral Surgery (50)	9 - Concept does not apply.
Physician Supervisions	09 - Concept does not apply.
Assistant Surgeon (80, 82)	9 - Concept does not apply.
Co-Surgeons (62)	9 - Concept does not apply.
Team Surgery (66)	9 - Concept does not apply.
Diagnostic Imaging Family	99 - Concept Does Not Apply
APC Status Indicator	Non-Covered Service, not paid under OPPS
Type of Service (TOS)	Q - Vision Items or Services
Berenson-Eggers TOS (BETOS)	M5C - Specialist - ophthalmology
MUE	0
CCS Clinical Classification	220 - Ophthalmologic and otologic diagnosis and treatment

GY	Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
58	Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
59	Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
AQ	Physician providing a service in an unlisted health professional shortage area (hpsa)
GA	Waiver of liability statement issued as required by payer policy, individual case
GZ	Item or service expected to be denied as not reasonable and necessary
LT	Left side (used to identify procedures performed on the left side of the body)
Q6	Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
RT	Right side (used to identify procedures performed on the right side of the body)