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Nevada MedicaidMedicaid · Coverage · Billing & Coding · NV · Ophthalmology, OptometryMedium impact

Attention Provider Types 20 (Physician, M.D., Osteopath, D.O.), 25 (Optometrist) and 41 (Optician, Optical Business): Billing Instructions for Combining Lens-Related Vision Codes

Act
immediately
Effective date
Nov 1, 2024
Identified
Jun 21, 2026

Summary

Nevada Medicaid has established new billing limitations for lens-related vision codes, restricting bifocal/trifocal width codes and prism add-on codes to 2 units per rolling year each, with treatment and coating codes having individual 2-unit limits. Claims previously denied with error code 5585 will be automatically reprocessed.

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What to do

immediately · 3 steps
01Billing team must update system to track rolling year limits for vision lens codes - maximum 2 combined units per year for bifocal/trifocal width codes (V2219, V2220, V2319, V2320), maximum 2 combined units per year for prism codes (V2710, V2715, V2718), and maximum 2 units per year for each individual treatment/coating code (V2730, V2745, V2750, V2755, V2760).
02Configure system to request prior authorization when limits are exceeded.
03Monitor remittance advices for automatically reprocessed claims that were previously denied with error code 5585.

Codes mentioned

V2219V2220V2319V2320V2710V2715V2718V2730V2745V2750V2755V2760

Original notice

Attention Provider Types 20 (Physician, M.D., Osteopath, D.O.), 25 (Optometrist) and 41 (Optician, Optical Business): Billing Instructions for Combining Lens-Related Vision Codes
medicaid.nv.gov · Always check the source before changing claims.
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Related changes

See all Nevada Medicaid changes →
Attention Provider Types 20 (Physician, M.D., Osteopath, D.O.), 25 (Optometrist), 41 (Optician, Optical Business): Age Restriction for Procedure Code V2760 Added in the Medicaid Management Information System (MMIS) to Match PolicyMediumEffective Jun 22, 2026 · Provider AnnouncementAttention Provider Types 20 (Physician, M.D., Osteopath, D.O.), 25 (Optometrist) and 41 (Optician, Optical Business): Update to Procedure Codes V2020 and V2750MediumEffective Nov 11, 2024 · Provider AnnouncementAttention Provider Type 20 (Physician, M.D., Osteopath, D.O.): Update on Claims for Procedure Code V2750 That Denied in ErrorLowEffective Sep 1, 2025 · Provider EnrollmentBrowse every Nevada Medicaid change in the policy list

Related policy hubs

Nevada Medicaid policiesNV policy changesOphthalmologyOptometryCode V2219Code V2220Code V2319Code V2320Code V2710Code V2715Code V2718Code V2730Code V2745Code V2750Code V2755Code V2760

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