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 |