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The CPT® Code 92342 refers to the fitting of spectacles, specifically multifocal lenses that are not bifocal, for patients who require corrective lenses due to conditions other than aphakia. Aphakia is a condition characterized by the absence of the lens of the eye, typically following cataract surgery. The fitting process involves a detailed evaluation of the patient's facial anatomy by a qualified spectacle technician. This technician assesses various anatomical features, including the distance between the pupils, to ensure that the selected frame and lenses will provide optimal vision correction and comfort. The technician then submits these measurements to a laboratory, where the lenses are manufactured and inserted into the chosen frame. Once the eyeglasses are completed, the patient returns for a fitting session. During this session, the technician evaluates the fit of the eyeglasses, making necessary adjustments to the bridge, nose pads, and temple arms to ensure that the spectacles sit properly on the patient's face. This meticulous fitting process is essential for achieving the best possible visual outcome and comfort for the patient.
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The fitting of spectacles using CPT® Code 92342 is indicated for patients who require multifocal lenses for vision correction due to conditions other than aphakia. This procedure is typically performed following a separately reportable eye examination that confirms the need for corrective lenses. The indications may include, but are not limited to, presbyopia, myopia, hyperopia, or other refractive errors that necessitate the use of multifocal lenses to improve the patient's visual acuity at various distances.
The procedure for fitting spectacles with CPT® Code 92342 involves several key steps to ensure that the eyeglasses are tailored to the patient's specific needs. Initially, the patient meets with a spectacle technician after a comprehensive eye examination. The technician begins by evaluating the patient's anatomical facial characteristics, which includes measuring the distance between the pupils. This measurement is crucial for determining the appropriate lens placement within the frame. Once the measurements are taken, the technician submits them to a laboratory where the lenses are manufactured according to the specifications provided.
After the fitting procedure is completed, the patient is advised on how to properly care for their new eyeglasses. This may include instructions on cleaning the lenses, adjusting the fit if necessary, and when to return for follow-up appointments if any issues arise. Patients are encouraged to wear their new spectacles regularly to adapt to the multifocal lenses and to report any discomfort or vision issues to their eye care provider promptly. Regular follow-up visits may be necessary to ensure that the eyeglasses continue to meet the patient's visual needs as their prescription may change over time.
| Short Descr | FIT SPECTACLES MULTIFOCAL | Medium Descr | FITTING SPECTACLES XCPT APHAKIA MULTIFOCAL | Long Descr | Fitting of spectacles, except for aphakia; multifocal, other than bifocal | 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 | 25 | Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service: it may be necessary to indicate that on the day a procedure or service identified by a cpt code was performed, the patient's condition required a significant, separately identifiable e/m service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. a significant, separately identifiable e/m service is defined or substantiated by documentation that satisfies the relevant criteria for the respective e/m service to be reported (see evaluation and management services guidelines for instructions on determining level of e/m service). the e/m service may be prompted by the symptom or condition for which the procedure and/or service was provided. as such, different diagnoses are not required for reporting of the e/m services on the same date. this circumstance may be reported by adding modifier 25 to the appropriate level of e/m service. note: this modifier is not used to report an e/m service that resulted in a decision to perform surgery. see modifier 57 for significant, separately identifiable non-e/m services, see modifier 59. | 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). | 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. | E1 | Upper left, eyelid | E3 | Upper right, eyelid | GA | Waiver of liability statement issued as required by payer policy, individual case | GW | Service not related to the hospice patient's terminal condition | GX | Notice of liability issued, voluntary under payer policy | KX | Requirements specified in the medical policy have been met | RA | Replacement of a dme, orthotic or prosthetic item | U6 | Medicaid level of care 6, as defined by each state |
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| 2013-01-01 | Changed | Short Descriptor changed. |
| Pre-1990 | Added | Code added. |
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