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Lenses

Aphakic Lenses

Post-cataract lenses are included in the Lenticular category and not under the aspheric lens enhancements. Laboratories are paid the trifocal base lens price. On Eyefinity orders, select "Lenticular" from the pull-down menu under Vision Type. For paper orders using the Materials Invoice form, choose the "Other" box and write "Lenticular" in the space provided.

Aspheric Lenses

Lens Enhancement Codes: BA, AB

Aspheric lenses ordered in standard plastic (CR-39) and polycarbonate are identified by the "BA" lens enhancement code. Mid-Index (1.53-1.59) plastic lenses are classified under lens enhancements code "AB." If aspheric lenses are ordered in High-Index materials (1.60 & and above), use the "BA" lens enhancements code in combination with the appropriate material lens enhancements code for aspheric lenses.

Digitally surfaced aspheric single vision lenses are covered using the "BA" lens enhancements code in combination with any other applicable lens enhancements codes. Do not use the "BA" for digitally surfaced progressive lenses. The progressive lens enhancements code includes reimbursement for digital surfacing.

Blended Bifocals

Lens Enhancement Code: GA

Charge the "GA" lens enhancement code for blended bifocals in standard plastic (CR-39).

Digital Lenses

Lens Enhancement Code: BA

Digitally surfaced aspheric single vision lenses are covered using the "BA" lens enhancement code in combination with any other applicable lens enhancement codes. Do not use the "BA" for digitally surfaced progressive lenses. The progressive lens enhancement code includes reimbursement for digital surfacing.

Executive Multifocals

Executive multifocals are covered for Signature and Choice Plan patients.

Lenticular

Laboratories are paid the trifocal lens price for Lenticular lenses. On Eyefinity orders, select "Lenticular" from the pull-down menu under Vision Type. For paper orders using the Materials Invoice form, choose the "Other" box and write "Lenticular" in the space provided.

Myo-Disc

Standard myo-disc orders are paid according to the trifocal lens price and categorized as "Lenticular" lenses for ordering and billing purposes. On Eyefinity orders, select "Lenticular" from the pull-down menu under Vision Type. For paper orders using the Materials Invoice form, choose the "Other" box and write "Lenticular" in the space provided. Blended myo-discs are not available for use with VSP benefits.

Near Variable Focus

Lens Enhancement Code: IA

Near variable focus lenses are categorized according to average market prices for the various designs. All designs within these lens enhancement codes were created for near and intermediate vision. If near variable focus lenses are ordered in materials other than standard 1.50 plastic, charge additionally for these lens enhancements.

Lens enhancement code IA applies to non-progressive conventionally or digitally surfaced near and intermediate designs or progressive styles engineered to optimize intermediate and near vision.

UV protection is an inherent quality of these materials; therefore, do not charge additionally for UV protection. Do not charge for factory scratch coating (category A) on near variable focus lenses.

On orders placed through Eyefinity, choose "Near Variable Focus" from the pull-down menu under Vision Type.

Occupational Lenses

Lens Enhancement Codes: CA, CE

Use lens enhancements code "CA" for plastic and "CE" for glass occupational lenses.  The following lenses are considered occupational lenses:

  • Doubles
    • Flat Top 28 (standard separation – 13 mm)
    • Flat Top 28 (special separation)
    • Flat Top 35 (standard separation – 13 mm)
    • Flat Top 35 (special separation)
  • Trifocals
    • CRT DataLite 14 x 35
    • CRT Executive
    • 10 x 35
    • 12 x 35
    • 14 x 35 Non-CRT 50% Intermediate
    • Acclaim 8 x 34 61% Intermediate
    • Acclaim 10 x 35 61% Intermediate
    • Acclaim 12 x 35 61% Intermediate
    • Acclaim 14 x 35 61% Intermediate

Single vision glass occupational lenses in specialty materials (i.e., Didymium and X-Ray glass) are not available for use with VSP benefits.

Plano Lenses

Minimum prescription requirements for orders must be met in order to quality for VSP coverage.  Plano lenses, including plano sunglass lenses, are not reimbursable unless specifically covered by the client.  See Minimum Prescription Requirements and Plano for further information.

Polarized Lenses

Lens Enhancement Codes: DA, DE, FP, JP, KP, NP, OP

Single vision and segmented multifocal plastic lenses are included under the lens enhancements code "DA."  Glass single vision and multifocal polarized lenses are included under lens enhancement code "DE."

If polarized lenses are ordered in mid-index plastic (1.53-1.59), high-index plastic 1.60, high-index plastic 1.66/1.67, or polycarbonate, charge additionally for the appropriate material.  These additional costs are listed in the lens enhancement fee schedules directly below the main lens charge (e.g., charge lens enhancement codes "DA" and "DD" for polarized lenses in polycarbonate).

Basic polarized lens colors are:

  • Gray A & C
  • Brown A & C
  • Yellow C
  • Green
  • Melanin

Do not charge for UV protection on polarized lenses, since the lens enhancement price includes inherent UV protection.

Progressive Lenses

Lens Enhancement Codes: FA, FE, JA, JE, KA, KE, NA, OA

Progressive lenses are categorized according to average market prices for the various designs. Placement within a particular code does not imply any type of endorsement from VSP regarding the quality or performance of any product. Refer to the Product Index to determine the correct lens enhancement code for each progressive lens design.

If a progressive lens is ordered in a material other than standard plastic (i.e., CR-39), charge additionally for the appropriate material. These additional costs are listed directly below the main lens charge (e.g., charge lens enhancement codes "JA" and "JD" for a Progressive J in polycarbonate). Laboratories are paid the bifocal bid price in addition to the progressive lens enhancement fee for all progressive lens orders.

There is no additional charge for factory scratch resistant coating (category A, lens enhancement code "QQ") on any progressive lens. If a progressive lens is available both with and without a factory applied scratch coating, always provide the coated version. If the progressive lens design is aspheric, this feature is built into the lens enhancement code. Do not charge extra for the aspheric component.

Uncuts

Uncut lenses can only be processed in the case of an emergency, typically determined by the Provider's office. The Provider will submit as a private order. This should only be done on very rare occasions.

Examples of emergencies include:

  • Loss, theft or breakage of prescription eyewear when patient doesn't own an alternate pair and can't wear contact lenses
  • Situations where patient can't function at work or school and doesn't have another pair of glasses or contact lenses
  • Patients whose safety and well-being will be jeopardized without the immediate delivery of their prescription eyewear

Emergency situations do not include:

  • Instances where a faster turn-around time is requested to accommodate trips, vacations, or other discretionary events
  • Providing faster service when patient has another functional pair of glasses or contacts