HCPCS Code Section: HCPCS V Codes

Trifocal seg width over 28 mm Short Description: Lens trifocal seg width > 28 Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, …

Aniseikonic lens, trifocal Short Description: Lens aniseikonic trifocal Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 1985 Effective Date: October 1, 2003 …

Lenticular, (myodisc), per lens, trifocal Short Description: Lens lenticular trifocal Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 1985 Effective Date: October …

Spherocylinder, trifocal, sphere over plus or minus 12.00d, per lens Short Description: Lens sphcyl trifocal over 12 Coverage Code: Carrier judgment Action Code: No maintenance for this code Date …

Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 4.25 to 6.00d cylinder, per lens Short Description: Lens sphc trifo 7.25-12/4.25 Coverage Code: Carrier judgment Action …

Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, 2.25 to 4.00d cylinder, per lens Short Description: Lens sphc trifo 7.25-12/2.25 Coverage Code: Carrier judgment Action …

Spherocylinder, trifocal, plus or minus 7.25 to plus or minus 12.00d sphere, .25 to 2.25d cylinder, per lens Short Description: Lens sphc trifo 7.25-12/.25- Coverage Code: Carrier judgment Action …

Contact lens, pmma, bifocal, per lens Short Description: Contact lens pmma bifocal Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, 1985 Effective …

Spherocylinder, trifocal, plus or minus 4.25 to plus or minus 7.00d sphere, over 6.00d cylinder, per lens Short Description: Lens sphc trifocal 4.25-7/>6 Coverage Code: Carrier judgment Action Code: …

Contact lens, pmma, toric or prism ballast, per lens Short Description: Cntct lens pmma-toric/prism Coverage Code: Carrier judgment Action Code: No maintenance for this code Date Added: January 1, …