I am sooo confused! I just came from doc's office for measurements and first surgery date, Oct 22. Both eyes have cataracts and I have mild astigmatism. I was told on a scale of A to D that I am a B in right eye and B- in left. I have to make a decision on which lens to opt for. It's been strongly suggested that I get the Acry Sof toric mono focal IOL instead of the standard mono focal. My insurance will totally pay for the standard, but it will cost me $950 out-of-pocket on each eye for the toric.
I've worn glasses since I was 12, so it's no biggie to continue and feel I look weird withiut them anyway. I'm unclear if there is a true advantage with the toric lens. Are there less issues with the standard lens? Is the toric worth the expense? Doc is not pressuring me, just gave me options. So now I'm confused. I've read some of forum comments and it's just added to my distress.
Please contact your insurance company yourself and get your coverage info. Do not leave it up to the doctors office to tell you your correct coverage. Get all the CPT codes necessary for the insurance company
It might also be possible to reduce your astigmatism with limbal relaxing incisions at the time of your cataract surgery. Some surgeons don't charge an additional fee for this procedure, and (in any case) it would certainly cost less than getting toric lenses.
CPT codes are the critical code numbers to tell your Insurance Co. when you call them for coverage information. They are the "procedure" codes that your Doctors office will bill to the insurance company. It is the first thing your Ins. company will ask for when you call them for coverage information.
I am just trying to hunt down CPT codes myself and found that you have to ask for the "Billing dept." of your Doctor's office and/or medical center where they will do the procedure. DON'T assume that one billing CPT code covers the entire procedure...ask specifically what other codes might be involved.
Also, I suggest you write down dates and names of people you speak to for documentation in case there is an expensive error. Remember, the insurance companies record the phone conversations so if you ever need that to prove a point, you can ask for the phone records. (Just pointing out the complexity of making sure you have the correct and complete CPT code for whatever procedure you are asking about.)
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