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Supported Payers and Coding
Details of supported payers for eligibility and claims
Supported Payers
| Payer | API code |
|---|---|
| VSP | insurer:vision:vsp |
| EyeMed | insurer:vision:eye_med |
| Spectera | insurer:vision:spectera |
| Davis Vision | insurer:vision:davis_vision |
| Superior Vision | insurer:vision:superior |
| Anagram Vision Demo Payer | insurer:demo:vision |
| Cigna Vision | insurer:vision:cigna_vision |
| Aetna Vision | insurer:vision:aetna_vision |
| Blue View | insurer:vision:blue_view |
VSP
- Insurer code:
insurer:vision:vsp
Features:
- supports claim submission using member ID (subscription ID) or SSN last four
Additional claim constraints:
- patient and primary member
sexmust be provided - diagnosis must be provided
List of recommended CPT/HCPCS codes:
| Codes | Description |
|---|---|
| 92002, 92004, 92012, 92014, 92015, S0620, S0621 | medical examination and evaluation |
| 92071, 92072, 92310, 92314 | contact lens fit |
| S0500 | contact lens |
| V2020, V2025 | frames |
| V21## | Sphere, single vision lens |
| V22## | Sphere, bifocal lens |
| V23## | Sphere, trifocal lens |
| V24## | asphericity lens |
| V25## | contact lens |
| V27## | add-ons |
Note that although the VSP claim form allows arbitrary CPT/HCPCS codes and our API supports the majority of them, we recommend using only the codes specified above to reduce the chance of claim rejections. Contact Anagram customer support if you need to use other codes.
Anagram Vision Demo
The Anagram Vision Demo insurer should be used for testing only. It does not interface with real insurance companies.
- Insurer code:
insurer:demo:vision - Claim form: out-of-network claim form
Features:
- supports claim submission using member ID (subscription ID) or SSN last four
We recommend using the same service types as VSP.
Eyemed
- Insurer code:
insurer:vision:eye_med
Features:
- supports claim submission using member ID (subscription ID)
Additional claim constraints:
- member id of the primary member must be provided
- patient member id must be provided if type is not
self
List of recommended CPT/HCPCS codes:
| Codes | Description |
|---|---|
| 92002, 92004, 92012, 92014, 92015, 92015-TG, 92225, 92226, 92230, 92250, 92260, 92265, S0592, S0620, S0621 | Medical examination and evaluation |
| 92071, 92072, 92310, 92310-21, 92310-22, 92314 | Contact lens fit |
| S0500, S0512, V2500, V2501, V2502, V2503, V2510, V2511, V2512, V2513, V2520, V2521, V2522, V2523, V2530, V2531, V2599, V2627 | Contact lens |
| V2020, V2025, S0516, S0518 | Frames |
| S0504, V2100. V2101, V2102, V2103, V2104, V2105, V2106, V2107, V2108, V2109, V2110, V2111, V2112, V2113, V2114, V2115, V2118, V2121, V2199, V2410 | Sphere, single vision lens |
| S0506, V2200, V2201, V2202, V2203, V2204, V2205, V2206, V2207, V2208, V2209, V2210, V2211, V2212, V2213, V2214, V2215, V2218, V2219, V2220, V2221, V2299 | Sphere, bifocal lens |
| S0508, V2300, V2301, V2302, V2203, V2204, V2205, V2206, V2207, V2208, V2209, V2310, V2311, V2312, V2313, V2314, V2315, V2318, V2319, V2320, V2321, V2399 | Sphere, trifocal lens |
| V2410, V2430, V2499 | Variable asphericity lens |
| V2781, S0581, V2781-26 | Progressive lens |
| V2760, V2745, V2755 | Add-ons |
Spectera
- Insurer code:
insurer:vision:spectera
Features:
- supports claim submission using member ID (subscription ID)
Additional claim constraints:
- member id of primary member must be provided
List of recommended CPT/HCPCS codes:
| Codes | Description |
|---|---|
| 92002, 92004, 92012, 92014, 92015, 92015-TG, 92225, 92226, 92230, 92250, 92260, 92265, S0592, S0620, S0621 | Medical examination and evaluation |
| 92071, 92072, 92310, 92310-21, 92310-22, 92314 | Contact lens fit |
| S0500, S0512, V2500, V2501, V2502, V2503, V2510, V2511, V2512, V2513, V2520, V2521, V2522, V2523, V2530, V2531, V2599, V2627 | Contact lens |
| V2020, V2025, S0516, S0518 | Frames |
| S0504, V2100. V2101, V2102, V2103, V2104, V2105, V2106, V2107, V2108, V2109, V2110, V2111, V2112, V2113, V2114, V2115, V2118, V2121, V2199, V2410 | Sphere, single vision lens |
| S0506, V2200, V2201, V2202, V2203, V2204, V2205, V2206, V2207, V2208, V2209, V2210, V2211, V2212, V2213, V2214, V2215, V2218, V2219, V2220, V2221, V2299 | Sphere, bifocal lens |
| S0508, V2300, V2301, V2302, V2203, V2204, V2205, V2206, V2207, V2208, V2209, V2310, V2311, V2312, V2313, V2314, V2315, V2318, V2319, V2320, V2321, V2399 | Sphere, trifocal lens |
| V2410, V2430, V2499 | Variable asphericity lens |
| V2781, S0581, V2781-26 | Progressive lens |
| V2760, V2761, V2744, V2745 | Coating |
| V2744 | Photochromatic |
| V2755 | UV Lens |
Davis Vision
- Insurer code:
insurer:vision:davis_vision
Features:
- supports claim submission using member ID (subscription ID)
Additional claim constraints:
- member id of primary member must be provided
List of recommended CPT/HCPCS codes:
| Codes | Description |
|---|---|
| 92002, 92004, 92012, 92014, 92015, 92015-TG, 92225, 92226, 92230, 92250, 92260, 92265, S0592, S0620, S0621 | Medical examination and evaluation |
| 92071, 92072, 92310, 92310-21, 92310-22, 92314 | Contact lens fit |
| S0500, S0512, V2500, V2501, V2502, V2503, V2510, V2511, V2512, V2513, V2520, V2521, V2522, V2523, V2530, V2531, V2599, V2627 | Contact lens |
| V2020, V2025, S0516, S0518 | Frames |
| S0504, V2100. V2101, V2102, V2103, V2104, V2105, V2106, V2107, V2108, V2109, V2110, V2111, V2112, V2113, V2114, V2115, V2118, V2121, V2199, V2410 | Sphere, single vision lens |
| S0506, V2200, V2201, V2202, V2203, V2204, V2205, V2206, V2207, V2208, V2209, V2210, V2211, V2212, V2213, V2214, V2215, V2218, V2219, V2220, V2221, V2299 | Sphere, bifocal lens |
| S0508, V2300, V2301, V2302, V2203, V2204, V2205, V2206, V2207, V2208, V2209, V2310, V2311, V2312, V2313, V2314, V2315, V2318, V2319, V2320, V2321, V2399 | Sphere, trifocal lens |
Cigna Vision
- Insurer code:
insurer:vision:cigna_vision
Features:
- supports claim submission using member ID (subscription ID) or SSN last four
Additional claim constraints:
- patient/primary member
sexmust be provided - diagnosis must be provided
List of recommended CPT/HCPCS codes:
| Codes | Description |
|---|---|
| 92002, 92004, 92012, 92014, 92015, S0620, S0621 | medical examination and evaluation |
| 92071, 92072, 92310, 92314 | contact lens fit |
| S0500 | contact lens |
| V2020, V2025 | frames |
| V21## | Sphere, single vision lens |
| V22## | Sphere, bifocal lens |
| V23## | Sphere, trifocal lens |
| V24## | asphericity lens |
| V25## | contact lens |
| V27## | add-ons |
Aetna Vision
- Insurer code:
insurer:vision:aetna_vision
Features:
- supports claim submission using member ID (subscription ID)
Additional claim constraints:
- member id of primary member must be provided
- patient member id must be provided if type is not
self
List of recommended CPT/HCPCS codes:
| Codes | Description |
|---|---|
| 92002, 92004, 92012, 92014, 92015, 92015-TG, 92225, 92226, 92230, 92250, 92260, 92265, S0592, S0620, S0621 | Medical examination and evaluation |
| 92071, 92072, 92310, 92310-21, 92310-22, 92314 | Contact lens fit |
| S0500, S0512, V2500, V2501, V2502, V2503, V2510, V2511, V2512, V2513, V2520, V2521, V2522, V2523, V2530, V2531, V2599, V2627 | Contact lens |
| V2020, V2025, S0516, S0518 | Frames |
| S0504, V2100. V2101, V2102, V2103, V2104, V2105, V2106, V2107, V2108, V2109, V2110, V2111, V2112, V2113, V2114, V2115, V2118, V2121, V2199, V2410 | Sphere, single vision lens |
| S0506, V2200, V2201, V2202, V2203, V2204, V2205, V2206, V2207, V2208, V2209, V2210, V2211, V2212, V2213, V2214, V2215, V2218, V2219, V2220, V2221, V2299 | Sphere, bifocal lens |
| S0508, V2300, V2301, V2302, V2203, V2204, V2205, V2206, V2207, V2208, V2209, V2310, V2311, V2312, V2313, V2314, V2315, V2318, V2319, V2320, V2321, V2399 | Sphere, trifocal lens |
| V2410, V2430, V2499 | Variable asphericity lens |
| V2781, S0581, V2781-26 | Progressive lens |
| V2760, V2745, V2755 | Add-ons |
Blue View
- Insurer code:
insurer:vision:blue_view
Features:
- supports claim submission using member ID (subscription ID)
Additional claim constraints:
- member id of primary member must be provided
- patient member id must be provided if type is not
self
List of recommended CPT/HCPCS codes:
| Codes | Description |
|---|---|
| 92002, 92004, 92012, 92014, 92015, 92015-TG, 92225, 92226, 92230, 92250, 92260, 92265, S0592, S0620, S0621 | Medical examination and evaluation |
| 92071, 92072, 92310, 92310-21, 92310-22, 92314 | Contact lens fit |
| S0500, S0512, V2500, V2501, V2502, V2503, V2510, V2511, V2512, V2513, V2520, V2521, V2522, V2523, V2530, V2531, V2599, V2627 | Contact lens |
| V2020, V2025, S0516, S0518 | Frames |
| S0504, V2100. V2101, V2102, V2103, V2104, V2105, V2106, V2107, V2108, V2109, V2110, V2111, V2112, V2113, V2114, V2115, V2118, V2121, V2199, V2410 | Sphere, single vision lens |
| S0506, V2200, V2201, V2202, V2203, V2204, V2205, V2206, V2207, V2208, V2209, V2210, V2211, V2212, V2213, V2214, V2215, V2218, V2219, V2220, V2221, V2299 | Sphere, bifocal lens |
| S0508, V2300, V2301, V2302, V2203, V2204, V2205, V2206, V2207, V2208, V2209, V2310, V2311, V2312, V2313, V2314, V2315, V2318, V2319, V2320, V2321, V2399 | Sphere, trifocal lens |
| V2410, V2430, V2499 | Variable asphericity lens |
| V2781, S0581, V2781-26 | Progressive lens |
| V2760, V2745, V2755 | Add-ons |
Superior
- Insurer code:
insurer:vision:superior
Additional claim constraints:
- member id of primary member must be provided
List of recommended CPT/HCPCS codes:
| Codes | Description |
|---|---|
| 92002, 92004, 92012, 92014, 92015-TG, S0592, S0620, S0621 | Medical examination and evaluation |
| 92310, 92314, S0592 | Contact lens fit |
| V2500, V2501, V2502, V2503, V2510, V2511, V2512, V2513, V2520, V2521, V2522, V2523, V2530, V2531, V2599 | Contact lens |
| V2020, V2025, S0516, S0518 | Frames |
| V2100, V2101, V2102, V2103, V2104, V2105, V2106, V2107, V2108, V2109, V2110, V2111, V2112, V2113, V2114, V2115, V2118, V2121, V2199, V2410 | Sphere, single vision lens |
| V2200, V2201, V2202, V2203, V2204, V2205, V2206, V2207, V2208, V2209, V2210, V2211, V2212, V2213, V2214, V2215, V2218, V2219, V2220, V2221, V2299, V2430 | Sphere, bifocal lens |
| V2300, V2301, V2302, V2303, V2304, V2305, V2306, V2307, V2308, V2309, V2310, V2311, V2312, V2313, V2314, V2315, V2318, V2319, V2320, V2321, V2399 | Sphere, trifocal lens |
| V2781 | Progressive lens |
| V2700, V2702, V2710, V2715, V2718, V2730, V2744, V2745, V2750, V2755, V2756, V2760, V2762, V2770, V2780, V2782, V2783, V2784, V2785, V2786, V2787, V2788, V2790, V2797, V2799 | Add-ons |
| V2115, V2121, V2215, V2221, V2315, V2321, V2410, V2430 | Other (Lens) |
| V2744, V2745, V2755, V2760, V2799, S0580 | Other (Coating) |
| V2799, S0580, S0581 | Other |
Frequently used ICD10 codes
| Code | Description |
|---|---|
| H04.121 | Dry eye syndrome of right lacrimal gland (H04.121) |
| H04.122 | Dry eye syndrome of left lacrimal gland (H04.122) |
| H04.123 | Dry eye syndrome of bilateral lacrimal glands (H04.123) |
| H04.129 | Dry eye syndrome of unspecified lacrimal gland (H04.129) |
| H11.151 | Pinguecula, right eye (H11.151) |
| H11.152 | Pinguecula, left eye (H11.152) |
| H11.153 | Pinguecula, bilateral (H11.153) |
| H11.159 | Pinguecula, unspecified eye (H11.159) |
| H25.011 | Cortical age-related cataract, right eye (H25.011) |
| H25.012 | Cortical age-related cataract, left eye (H25.012) |
| H25.013 | Cortical age-related cataract, bilateral (H25.013) |
| H25.019 | Cortical age-related cataract, unspecified eye (H25.019) |
| H44.20 | Degenerative myopia, unspecified eye (H44.20) |
| H44.21 | Degenerative myopia, right eye (H44.21) |
| H44.22 | Degenerative myopia, left eye (H44.22) |
| H44.23 | Degenerative myopia, bilateral (H44.23) |
| H52.00 | Hypermetropia, unspecified eye (H52.00) |
| H52.01 | Hypermetropia, right eye (H52.01) |
| H52.02 | Hypermetropia, left eye (H52.02) |
| H52.03 | Hypermetropia, bilateral (H52.03) |
| H52.10 | Myopia, unspecified eye (H52.10) |
| H52.11 | Myopia, right eye (H52.11) |
| H52.12 | Myopia, left eye (H52.12) |
| H52.13 | Myopia, bilateral (H52.13) |
| H52.201 | Unspecified astigmatism, right eye (H52.201) |
| H52.202 | Unspecified astigmatism, left eye (H52.202) |
| H52.203 | Unspecified astigmatism, bilateral (H52.203) |
| H52.209 | Unspecified astigmatism, unspecified eye (H52.209) |
| H52.211 | Irregular astigmatism, right eye (H52.211) |
| H52.212 | Irregular astigmatism, left eye (H52.212) |
| H52.213 | Irregular astigmatism, bilateral (H52.213) |
| H52.219 | Irregular astigmatism, unspecified eye (H52.219) |
| H52.221 | Regular astigmatism, right eye (H52.221) |
| H52.222 | Regular astigmatism, left eye (H52.222) |
| H52.223 | Regular astigmatism, bilateral (H52.223) |
| H52.229 | Regular astigmatism, unspecified eye (H52.229) |
| H52.31 | Anisometropia (H52.31) |
| H52.32 | Aniseikonia (H52.32) |
| H52.4 | Presbyopia (H52.4) |
| H52.6 | Other disorders of refraction (H52.6) |
| H52.7 | Unspecified disorder of refraction (H52.7) |
| Z01.00 | Encounter for examination of eyes and vision without abnormal findings (Z01.00) |
| Z01.01 | Encounter for examination of eyes and vision with abnormal findings (Z01.01) |
| Z46.0 | Encounter for fitting and adjustment of spectacles and contact lenses (Z46.0) |