may 2009

INTRAOCULAR LENSES

IOL’s that receive an additional $50 payment
Billed using HCPCS code Q1003

AMO — Tecnis Z9000, Z9001, Z9002, ZA9003, AR40xEM, Tecnis 1-Piece IOL ZCB00
Alcon — AcrySof IQ SN60WF, Acrysert Delivery System Model SN60WS

Bausch and Lomb — Sofport LI61AO, LI61AOV, Akreos AO

Hoya — FY-60AD

STARR — Affinity Collamer CQ2015A, CC4204A, Elastimdie AQ2015A

P-C IOL’s
Additional cost of the lens and services can be billed to a Medicare beneficiary, use HCPCS code V2788

Bausch & Lomb — Crystalens

AMO — ReZoom (NXG1), Tecnis Silicone Intraocular lens (Model ZM900),
             Tecnis Multifocal Acrylic Intraocular lens (Model ZMA00)

Alcon — AcrySof RESTOR (SN60D3), AcrySof RESTOR Apodized Diffractive Aspheric Posterior Chamber,
             Intraocular lens models: SN6AD1 and SN6AD3

A-C IOL’s
Additional cost of the lens and services can be billed to a Medicare beneficiary, use HCPCS code V278

Alcon — AcrySof Toric IOL’s SN60T3, SN60T4, SN60T5
              AcrySof IQ Toric IOL’s SN6AT4, SN6AT5, SN6AT6
             (Collectively referred to as SN6ATT)

STAAR — Silicon 1P Toric IOL’s AA4203TF, AA4203T