## **What is the HCPCS code V2520 for?**
The HCPCS code V2520 is a V code, meaning it's part of a massive group of codes under the HCPCS code category Vision, Hearing, and Speech-Language Pathology Services. For this code, what is being designated is the provision of a spherical soft contact lens made of hydrophilic materials. This type of contact lens allows oxygen to pass through the cornea, which can improve the clarity of those with vision issues. It also provides additional comfort, especially for extended wear.
This is meant to be provided to patients with blurry vision due to myopia, hyperopia, or astigmatism, especially to those who experience discomfort with eyeglasses. Please note that this isn't meant for those with ocular surface diseases.
## **Documentation requirements for V2520**
As with any HCPCS code, it's important for you to have sufficient documentation to avoid claim rejections. For this code, here are some of what you need:
- The full name of the patient/beneficiary
- The full names and credentials of the professionals who handled the patient/beneficiary
- A valid prescription for this type of lens
- Documentation and medical records to justify the medical necessity of choosing this type of lens over others such as standard soft multifocal lenses, PMMA scleral lenses, full scleral lenses, corneoscleral lenses, bandage contact lenses, aspheric multifocal GP lenses, translating multifocal GP lenses, prescription lenses, standard soft toric lenses, etc.
- Documentation of the contact lens fitting portion of the patient's evaluation
- Documentation of any other eye-related procedures that the patient has had, if any (such as refractive surgery, fitting scleral lenses in the past, etc.)
- Lens specifications in the patient's record (lens material, base curve, diameter, power)
- Clear indication of whether the patient is a specialty lens patient
- Clear indication of how many lenses are provided
## **Billing requirements for V2520**
Besides the documentation requirements above, please make sure to take note of or have the following:
- 1 lens is equal to 1 unit; so if you dispense lenses for both eyes, you must bill 2 units
- Replacement lenses may be billed if medically necessary and allowed by payer policy
- This code is only for the lens itself. A fitting fee must be billed separately (e.g., CPT code 92310 for contact lens services/fitting)
- Use modifiers RT (for the right lens) or LT (for the left), or both
Please familiarize yourself with the relevant coding guidelines and related policy articles tied to your insurer and locality. This is so you can practice correct guidelines and avoid claim rejections.
### **Sample appropriate ICD codes to use**
You must also use the appropriate ICD codes related to the eye condition of your patient. Here are examples:
- **H52.13** - Myopia, bilateral
- **H52.203** - Unspecified astigmatism, bilateral
- **H52.03** - Hypermetropia, bilateral
Other similar or related codes
- **V2510** - Contact lens, gas permeable, spherical, per lens
- **V2511** - Contact lens, gas permeable, toric, prism ballast, per lens
- **V2521** - Contact lens, hydrophilic, toric, or prism ballast, per lens
- **V2522** - Contact lens, hydrophilic, bifocal, per lens
- **V2599** - Contact lens, other type
Frequently asked questions
