CPT® 92072 Fitting of contact lens for management of keratoconus — initial fitting

CPT 92072 is medically necessary for members when there is a documented diagnosis of keratoconus and objective clinical findings demonstrating that a specialty contact lens is required to improve visual function and/or prevent vision loss (including risk of amblyopia in children), and conservative spectacle or standard soft contact lens correction is inadequate or not tolerated. Documentation must support the diagnosis, show the reason spectacles/standard lenses are inadequate, and include corneal imaging or slit-lamp findings.