jaeacme.blogg.se - Progressive lense edge blending

#Progressive lense edge blending code#

Bilateral plano glasses are payable as safety glasses for persons with one remaining functioning eye.Oversize lenses are not covered except to replace lenses only.Trifocals are payable only for persons currently wearing them for specific job requirements.No additional payment is made for blended or progressive bifocal lenses.

#Progressive lense edge blending code#

Precertification is not needed if tinting is for one of the listed conditions however, the ICD-9-CM diagnosis code on the claim must support the need. The tint or coat should allow use of the lenses indoors and at night.

Tinted or color-coated corrective lenses are payable only for persons with aphakia, albinism, glaucoma or other medical conditions excluding photophobia not associated with such conditions.

This type of special coating is not to be confused with those used specifically to color or tint lenses to reduce light transmission. Polycarbonate lenses are covered but must be precertified for patients age 21 years and older. Glass must conform to standard Z-80 (National Bureau of Standards).

A new 24-month or 12-month period begins with the new pair of eyewear. The old and new prescriptions must be on the claim to document the change. A new pair within the 24-month or 12-month period, depending on the patient's age, is payable if the change in prescription meets the guidelines above.

For patients younger than 21, the benefit is once in a 12-month period.

The lenses benefit is limited to once in a 24-month period for patients age 21 years and older.

Refractive correction for a change in prescription is (+) or (-) 0.50 diopter, sphere or cylinder, or 6 degrees in cylinder axis for both eyes.

Refractive correction criteria for an original prescription is (+) or (-) 0.50 diopter, sphere or cylinder, or 1 vertical or 5 horizontal prism diopters for each eye.