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MA07.029e, Refractive Lenses
Effective date
Not stated in the notice
Identified
Jun 19, 2026
Summary
This is a reissue of MA07.029e with no substantive changes to coverage criteria or billing requirements. The policy was reissued on 12/19/2025 as part of Independence Blue Cross's annual review process for Medicare Advantage plans in New Jersey. The most recent material change was 10/01/2023, when HCPCS code V2526 (Contact lens, hydrophilic, with blue-violet filter, per lens) was added.
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What to do
Action · 4 steps
01No immediate action required.
02This reissue contains no changes to coverage criteria, billing codes, or reimbursement methodology.
03Billing team should confirm that current billing software and workflows align with existing policy requirements for refractive lenses (frames, lenses, and lens features) for Medicare Advantage members with aphakia, pseudophakia, or congenital aphakia.
04Retain this policy version (12/19/2025 reissue) as the current reference for New Jersey MA lines of business.
Codes mentioned
V2020V2100V2101V2102V2103V2104V2526V2744V2745V2750V2755V2780V2784S0580H26.40H27.00H27.01H27.02H27.03Q12.3Z96.1Z98.41Z98.42Z98.49
Original notice
MA07.029e, Refractive Lenses
medpolicy.ibx.com · Always check the source before changing claims.
Related changes
See all Independence Blue Cross changes →Related policy hubs
Independence Blue Cross policiesNJ policy changesOphthalmologyOptometryCode V2020Code V2100Code V2101Code V2102Code V2103Code V2104Code V2526Code V2744Code V2745Code V2750Code V2755Code V2780Code V2784Code S0580Code H26.40Code H27.00Code H27.01Code H27.02Code H27.03Code Q12.3Code Z96.1Code Z98.41Code Z98.42Code Z98.49