MedicaidBilling CodesMedium impact
Newsletter Vol. 12, No. 43
New Jersey Medicaid·NJ · Ophthalmology, Optometry·Medical Policy
Effective date
May 1, 2002
We identified it
Jun 20, 2026
Summary
New Jersey Medicaid/NJFC FFS will deny payments using Error Code 702 when providers bill for both polycarbonate and ultraviolet lens treatments on the same lens. Prior authorization remains required for special optical tints, polycarbonate lenses, and ultraviolet filter lenses when medically indicated. The policy also warns providers that fraudulent billing for lens treatments not rendered will result in criminal/civil penalties.
Action Required
Immediately: (1) Billing team must update claim denial protocols to recognize Error Code 702 and deny concurrent polycarbonate (Y5201) and ultraviolet filter (V2755) lens treatment billing on the same lens in NJ Medicaid/NJFC FFS claims. (2) Providers must cease billing for both lens treatments simultaneously on a single lens or claims will be automatically denied. (3) Billing team must audit outstanding claims for concurrent Y5201 and V2755 billing and resubmit as corrected claims with only medically necessary treatment. (4) Train all vision care providers and billing staff that prior authorization is required before dispensing polycarbonate or UV filter lenses, with written clinical justification from the prescribing practitioner. Document all prior auth requests in system. Failure to comply will result in claim denials and potential fraud investigation by Bureau of Program Integrity.