Kentucky providers: Modifier codes are required for polycarbonate lenses

June 2023

Per your provider contract, a modifier code is required when billing for polycarbonate lenses. All polycarbonate claims submitted without a modifier will be denied. Please see the table below for which modifier codes to use.

Lens type Modifier
Polycarbonate SV (per lens) V2784 L1
Polycarbonate BF (per lens) V2784 L2
Polycarbonate TF (per lens) V2784 L3
Polycarbonate PAL (per lens) V2784 L4