Billing Guidelines for Code 92310
Either an ophthalmologist or optometrist may bill 92310.
- 92310 should only be billed at the time of original contact lens
prescription and fitting.
- When the provider performs a contact lens evaluation, over and above
the standard eye exam, bill either an S0620 or S0621 (standard eye exam)
and the 92310 (contact lens evaluation).
- Benefit language states that this service is included in the contact
lens limitation. If contact lens benefit has not been met, all or a portion
of the 92310 could be paid. However, once the patient has met their benefit
limit for the contacts, 92310 will be denied as member liability.
