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3.3.8.4.1 Temporary Contact Lenses
When temporary contact lenses are necessary for a client after cataract surgery, the most appropriate lens procedure code may be reimbursed with prior authorization when billed with diagnosis code V431 (lens organ or tissue replacement).
Temporary contact lenses may be considered for reimbursement up to four months after surgery until the client is ready for their permanent lenses. The date of surgery is required to determine the convalescence period for temporary prosthetic eyewear. There are no limitations on the number of necessary temporary prosthetic lenses during the postsurgical convalescence period. Temporary lenses are not payable if dispensed after the four-month convalescence period.
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