LOG IN TO ORDER

Use your Online Ordering ID to access your account.

Learn more.

Common Coding Options for AcrySof®
Intraocular Lenses used in Cataract Surgery

Model

Description

CMS Payment Category

HCPCS Code

SN60WF
AU00T0
AcrySof® IQ Intraocular Lens ...with UltraSert™ Pre-loaded IOL Delivery System Packaged service/item; no separate payment made V2632 – Posterior chamber intraocular lens
SN60WS
SN6CWS
AcrySof® IQ Intraocular Lens ...with AcrySert® Delivery System Packaged service/item; no separate payment made V2632 – Posterior chamber intraocular lens
SN6AD1
SN6AD3
MN6AD1
AcrySof® IQ ReSTOR® Intraocular Lens Two-aspect reimbursement; See CMS Ruling 05-01 regarding patient responsibility for presbyopia-correcting IOLs V2788 – Presbyopia-correcting function of intraocular lens (See sample claim forms for proper use of modifiers and diagnosis.)
SV25T0 AcrySof® IQ ReSTOR® +2.5 multifocal IOL (Covered conventional IOL component may be reported as V2632)
SND1T3
SND1T4
SND1T5
SND1T6
AcrySof® IQ ReSTOR® +3.0 multifocal Toric (Covered conventional IOL component may be reported as V2632)
SN6AT3
SN6AT4
SN6AT5
SN6AT6
SN6AT7
SN6AT8
SN6AT9
AcrySof® IQ Toric Intraocular Lens Two-aspect reimbursement; See Ruling CMS-1536-R regarding patient responsibility for astigmatism-correcting IOLs V2787 – Astigmatism-correcting function of intraocular lens (See sample claim forms for proper use of modifiers and diagnosis.)

(Covered conventional IOL component may be reported as V2632)
SV25T3
SV25T4
SV25T5
Acrysof® IQ ReSTOR® +2.5 multifocal Toric IOL Two-aspect reimbursement; See CMS Ruling 05-01 regarding patient responsibility for presbyopia-correcting IOLs V2788 – Presbyopia-correcting function of intraocular lens (See sample claim forms for proper use of modifiers and diagnosis.)

(Covered conventional IOL component may be reported as V2632)
SN60AT
SA60AT
AcrySof® Single-Piece Intraocular Lenses Packaged service/item; no separate payment made V2632 – Posterior chamber intraocular lens
MN60AC
MA30AC
MA60AC
MA50BM
MN60MA
MA60MA
AcrySof® Multi-Piece Intraocular Lenses Packaged service/item; no separate payment made V2632 – Posterior chamber intraocular lens
MTA3U0
MTA4U0
MTA5U0
AcrySof® Anterior Chamber Intraocular Lenses Packaged service/item; no separate payment made V2630 – Anterior chamber intraocular lens

For models not listed, please contact ARS at (866) 457-0277 or use the Contact ARS form.


Additional Resources

An explanatory video for surgeons and staff that suggests how to talk to patients about ATIOL charges using an easy-to-understand, two-service billing concept.

VIEW IMPORTANT PRODUCT INFORMATION FOR:

AcrySof® IQ ReSTOR® Family of Multifocal IOLs IMPORTANT PRODUCT INFORMATION

CAUTION: Federal (USA) law restricts this device to the sale by or on the order of a physician.

INDICATIONS: The AcrySof® IQ ReSTOR® Posterior Chamber Intraocular Multifocal IOLs include AcrySof® IQ ReSTOR® and AcrySof® ReSTOR® Toric and are intended for primary implantation for the visual correction of aphakia secondary to removal of a cataractous lens in adult patients with and without presbyopia, who desire near, intermediate and distance vision with increased spectacle independence. In addition, the AcrySof IQ ReSTOR Toric IOL is intended to correct pre-existing astigmatism. The lenses are intended to be placed in the capsular bag.

WARNINGS/PRECAUTIONS: Careful preoperative evaluation and sound clinical judgment should be used by the surgeon to decide the risk/benefit ratio before implanting a lens in a patient with any of the conditions described in the Directions for Use labeling for each IOL. Physicians should target emmetropia, and ensure that IOL centration is achieved. Care should be taken to remove viscoelastic from the eye at the close of surgery.

The ReSTOR Toric IOL should not be implanted if the posterior capsule is ruptured, if the zonules are damaged, or if a primary posterior capsulotomy is planned. Rotation can reduce astigmatic correction; if necessary lens repositioning should occur as early as possible prior to lens encapsulation.

Some patients may experience visual disturbances and/or discomfort due to multifocality, especially under dim light conditions. A reduction in contrast sensitivity may occur in low light conditions. Visual symptoms may be significant enough that the patient will request explant of the multifocal IOL. Spectacle independence rates vary; some patients may need glasses when reading small print or looking at small objects.

Posterior capsule opacification (PCO), when present, may develop earlier into clinically significant PCO with multifocal IOLs. Prior to surgery, physicians should provide prospective patients with a copy of the Patient Information Brochure available from Alcon informing them of possible risks and benefits associated with the AcrySof® IQ ReSTOR® IOLs.

Do not resterilize; do not store over 45° C; use only sterile irrigating solutions such as BSS® or BSS PLUS® Sterile Intraocular Irrigating Solutions.

ATTENTION: Reference the Directions for Use labeling for each IOL for a complete listing of indications, warnings and precautions.

UltraSertTM Pre-loaded IOL Delivery System with the AcrySof® IQ aspheric IOL IMPORTANT PRODUCT INFORMATION

CAUTION: Federal (USA) law restricts this device to the sale by or on the order of a physician.

INDICATIONS: The AcrySof IQ aspheric intraocular lens (“AcrySof IQ”) is intended for the replacement of the human lens to achieve visual correction of aphakia in adult patients following cataract surgery. This lens is intended for placement in the capsular bag.

WARNINGS/PRECAUTIONS: Use the UltraSertTM Pre-loaded Delivery System (“UltraSert”) at temperatures between 18o C (64o F) and 23oC (73o F). Use only Alcon viscoelastics qualified for this device. Do not use the UltraSert if the nozzle appears damaged or deformed. Follow the Directions for Use for correct order and sequence of steps to avoid damage to the IOL or the UltraSertTM.

Careful preoperative evaluation and sound clinical judgement should be used by the surgeon to decide the risk/benefit ratio before implanting a lens in a patient with any of the conditions described in the Directions for Use. Caution should be used prior to lens encapsulation to avoid lens decentrations or dislocations.

Studies have shown that color vision discrimination is not adversely affected in the individuals with the AcrySof® Natural IOL and normal color vision. The effect on vision of the AcrySof® Natural IOL in subjects with hereditary color vision defects and acquired color vision defects secondary to ocular disease (e.g., glaucoma, diabetic retinopathy, chronic uveitis, and other retinal or optic nerve diseases) has not been studied. Do not resterilize: do not store over 45o C.

ATTENTION: Reference the Directions for Use for Model AU00T0 for a complete listing of indications, warnings and precautions.