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Alaska Medicaid Policy Clarification: Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) Devices
Act
immediately
Effective date
Sep 7, 2022
Identified
Jun 21, 2026
Summary
Alaska Medicaid has clarified coverage and billing requirements for PROSE (Prosthetic Replacement of the Ocular Surface Ecosystem) devices. The policy establishes different coding requirements for scleral cover shells (V2627) versus scleral contact lenses (V2531), with prior authorization required for cover shells and medical documentation required for contact lenses.
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What to do
immediately · 5 steps
01Billing team must update Alaska Medicaid billing procedures for PROSE devices.
02For scleral cover shells (V2627), obtain prior authorization before providing services.
03For scleral contact lenses (V2531), ensure medical records justifying medical need and invoice are submitted with all claims.
04Update billing system to require RT/LT modifiers for all PROSE device codes and bill bilateral services on separate claim lines.
05Claims without proper documentation or prior authorization will be denied.
Codes mentioned
V2627V2531L9900V262892071920729231092311923129231392314
Original notice
Alaska Medicaid Policy Clarification: Prosthetic Replacement of the Ocular Surface Ecosystem (PROSE) Devices
extranet-sp.dhss.alaska.gov · Always check the source before changing claims.