Question 1

What is HCPCS code V2213?

Accepted Answer

HCPCS code V2213 is "Lens sphcyl bifo 7.25-12/4.2". Spherocylinder, bifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens

Question 2

What category is V2213 in?

Accepted Answer

V2213 belongs to HCPCS Category V (Vision and Hearing Services).

Question 3

When should I use HCPCS code V2213?

Accepted Answer

Use V2213 when billing for lens sphcyl bifo 7.25-12/4.2. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is V2213 covered by Medicare?

Accepted Answer

Coverage for V2213 (Lens sphcyl bifo 7.25-12/4.2) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for V2213?

Accepted Answer

Documentation for V2213 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).