Health Information Management

Use C code for new technology IOLs

APCs Insider, January 26, 2004

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Use C code for new technology IOLs

QUESTION: In most of our cataract surgeries, it is required for the physician to implant a lens. We are paid for the insertion, but not the lens itself. Is there a HCPCs code we can use for Medicare to pay for the lens?

ANSWER: Under APCs, the reimbursement for lenses, or intraocular lenses (IOLs), has been included in the reimbursement for the procedure. However, CMS does want providers to bill for the lens using revenue code 276.

Most IOLs do not have a HCPCS code. There is a C code for new technology IOLs: C1780, "Lens, intraocular (new tech)." Although there is no separate APC payment for this code, we recommend that you report it if you are using new technology IOLs.



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