MedC

Question 1

10910

Answer 1

Comprehensive every 3yrs if <65yo
Initial consult

Question 2

10911

Answer 2

Comprehensive every year if >65yo
Initial Consult

Question 3

10916

Answer 3

initial consult
Short appts <15min

Question 4

10907

Answer 4

2nd comprehensive w DIFFERENT OPTOM (within 3yrs if <65yo OR 1yr if >65yo)
initial consult
2nd opinion

Question 5

10905

Answer 5

referred by another optom

Question 6

10918

Answer 6

subsequent consult related to previous course of action
- have to have attended practise

Question 7

10912

Answer 7

sig change in visual functions but <3yrs since last comprehensive
OLD presentation that has changed (e.g. VA drop, VF loss)
- have to have attended practise

Question 8

10913

Answer 8

NEW signs/symptoms
- have to have attended practise

Question 9

10914

Answer 9

progressive disorder e.g. glauc, AMD, cataract
initial consult sooner than every yr (<65yo) or 3yrs (>65yo)
- condition doesn’t have to have progressed
- doesn’t have to have attended practise before

Question 10

10915

Answer 10

Diabetic- must dilate
- doesn’t have to have attended practise before

Question 11

10940

Answer 11

bilateral automated perimetry
bill on top of initial consult
max 2x year
if indicated only

Question 12

10941

Answer 12

unilateral automated perimetry
bill on top of initial consult
must be indicated
max 2x year

Question 13

10921

Answer 13

CL >/= 5D myopia

Question 14

10922

Answer 14

CL >/= 5D hyperopia

Question 15

10923

Answer 15

CL >/= 3D astig

Question 16

When can you bill CL fitting through medicare

Answer 16

every 3 years
only need to meet criteria in ONE eye
spherical equivalent

Question 17

10924

Answer 17

advanced CL fitting
irregular astig (<6/12 spec VA)

Question 18

10925

Answer 18

advanced CL fitting
>/= 3D anisometropia

Question 19

10942

Answer 19

Low Vision Assessment <6/15 VA

Question 20

10943

Answer 20

Children b/w 3-14yo
Can be used with another code if more comprehensive workup/child requires more time

Question 21

10944

Answer 21

FB removal corneal
CAN’T be used with any other item

Question 22

10945-10948

Answer 22

Telehealth

Question 23

10928

Answer 23

Advanced CL fitting
Can’t wear spx

Question 24

10929

Answer 24

Advanced CL Fitting
Medical Reason

Question 25

10930

Answer 25

Change in CL material, parameters, functional change in eye, allergic response within 3 yrs

Question 26

10926

Answer 26

Advanced CL Fitting Telescopic system

Question 27

Which of the subsequent consults does px not have to have been seen in your practise before

Answer 27

10914 10915

Question 28

Which of the subsequent consults does px have to have been seen at your practise before

Answer 28

10912 10913 10918

Question 29

children

Answer 29

10943 can be used with another code

Question 30

FB removal

Answer 30

10944 can't be used with any other medicate code

Question 31

low vision px (what vision constitutes low vision too)

Answer 31

10942 <6/15 VA