OptumHealth Vision (Spectera) Modifier Codes
Transcription
OptumHealth Vision (Spectera) Modifier Codes
OptumHealth Vision (Spectera) Modifier Codes In this document: • Mapping Contact Lens Modifier Codes, 1 • OptumHealth Vision Contact Lens Modifier Codes, 3 As of July 1, OptumHealth Vision (Spectera) will require that all contact lens claims be submitted with contact lens modifier codes. This document tells you how to update your AcuityLogic system so that modifier codes are added to contact lens claims for OptumHealth Vision. If you use AcuityLogic On Premises, follow the instructions in this document to map your OptumHealth Vision formulary lenses to the appropriate contact lens modifiers. If you use AcuityLogic On Demand, your AcuityLogic system has been updated so that all OptumHealth Vision formulary lenses are mapped to the appropriate contact lens modifiers. After contact lenses are mapped to their corresponding modifier codes, the correct modifier codes will be automatically added to claims when billing OptumHealth Vision for contact lenses. If needed, contact OptumHealth Vision for a complete list of modifier codes or a billing guide. NOTE Mapping Contact Lens Modifier Codes This document was last updated on June 25, 2012. This document is subject to change at any time without notice. This section tells you how to map covered disposable contact lenses and monthly planned replacement contact lenses. You do not need to map non-covered contact lenses, as these will be mapped for you. 1. Review the table “OptumHealth Vision Contact Lens Modifier Codes” on page 4 to determine which contact lenses need to be mapped to which modifier codes. 2. From AcuityLogic Admin, click Product, select Contact Lens, and select Contact Lens. The Contact Lens window opens. 3. Search for a contact lens that you want to map. ® OptumHealth Vision (Spectera) Modifier Codes 1 OptumHealth Vision (Spectera) Modifier Codes Mapping Contact Lens Modifier Codes 4. Click the Mapping Partners hyperlink in the row of the contact lens you want to map. The Partner Mapping window for that contact lens opens. 5. Click the Edit hyperlink in the Spectera Modifier Codes row, type the two-letter OptumHealth Vision contact lens modifier code in the Code 1 text box, and click Update. NOTE For a list of modifier codes, refer to the table “OptumHealth Vision Contact Lens Modifier Codes” on page 4. 6. Click Return to close the window. 7. Repeat steps 2–6 for each contact lens on the OptumHealth Vision formulary. 2 OptumHealth Vision (Spectera) Modifier Codes OptumHealth Vision (Spectera) Modifier Codes OptumHealth Vision Contact Lens Modifier Codes OptumHealth Vision Contact Lens Modifier Codes The table below lists all contact lenses in the OptumHealth Vision (Spectera) formulary and their corresponding modifier codes: Contact Lens Modifier Code Ciba DAILIES AquaComfort Plus® 30 pack CD Ciba Focus® DAILIES® Toric ADC 30 pack CD Ciba Focus® DAILIES® Progressives 30 pack CD CooperVision™ Proclear® 1 day 30 pack CD 2Clear I Day 30 pack CD EasyWear 1 Day 30 pack CD Johnson & Johnson 1 Day Acuvue® Moist® 30 pack CD Bausch & Lomb® Soflens® 38 CD CIBA Vision Freshlook® Handling Tint CD CooperVision™ Avaira® CD Aquaclear 100 CD Aquatech Plus CD EasyWear 100 CD Sofmed Breathables CD CooperVision™ Biomedics® XC CD 2Clear XC CD CooperVision™ Biomedics® 55 Premier™ CD Sofmed 55 CD Johnson & Johnson ACUVUE® ADVANCE® Plus CD Johnson & Johnson ACUVUE® CD Johnson & Johnson ACUVUE® 2 CD Johnson & Johnson ACUVUE® OASYS® with HYDRACLEAR® Plus CD CIBA Vision AIR OPTIX® AQUA CM CooperVision™ Biofinity® CM Aquaclear CM CooperVision™ Frequency® 55 Aspheric CM Provision Premium Aspheric CM 2Clear Premium CM CooperVision™ Frequency® 55 CM OptumHealth Vision (Spectera) Modifier Codes 3 OptumHealth Vision (Spectera) Modifier Codes OptumHealth Vision Contact Lens Modifier Codes Contact Lens Modifier Code 2Clear CM Provision 55 Sphere CM CooperVision™ Proclear® CM Table 1-1: 4 OptumHealth Vision Contact Lens Modifier Codes OptumHealth Vision (Spectera) Modifier Codes