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Elizabeth M. Whitehorn, Director

Provider Notice issued 01/22/08

Change in Billing Policy for Contact Lens Prescription and Fitting Service

To​

Enrolled Optometrists, Optical Companies, and Physicians

​Date: ​January 22, 2008
​Re:

Change in Billing Policy for Contact Lens Prescription and Fitting Service​

The purpose of this notice is to advise providers of a change to the department’s billing policy for the prescription and fitting of contact lenses.

Effective immediately, the department will accept prior approval requests for procedure code 92310 whenever the provider feels it is medically necessary for the patient to receive this service. The previous limitation regarding procedure code 92310 has been removed. The service must meet the criteria as set forth in Current Procedural Terminology (CPT®), Fourth Edition.

As a reminder, HFS encourages providers that have not yet obtained NPIs to do so immediately. To apply for an NPI, visit the National Plan/Provider Enumeration System (NPPES) Web site at: <https://nppes.cms.hhs.gov/>. Providers who have obtained NPIs, but have not reported their NPI information to HFS should do so immediately. You may report your NPI information by going to the MEDI Web site at: www.myhfs.illinois.gov 

In addition, providers should ensure that all of their payees have obtained and reported their NPIs to the department. The informational notice on the NPI requirement sent to payees can be accessed on the department’s Web site.

Any questions regarding this notice may be directed to the Bureau of Comprehensive Health Services at 877-782-5565.

Theresa Eagleson Wyatt

Acting Administrator

Division of Medical Programs