A241

PDF page 288 / A160

Optometrist-requested assessment for Neuro-ophthalmic Disorders
     Optometrist-requested assessment for neuro-ophthalmic disorders is an assessment in which
     the ophthalmologist provides all the elements of an Optometrist-Requested Assessment
     (A253) for a patient with a neuro-ophthalmic disorder.
 A241 Optometrist-requested assessment for neuro-ophthalmic
          disorders............................................................................. 155.45
      Payment rules:
      1.A241 is only eligible for payment when at least four of the following are documented as a part
        of the examination:
          a.Detailed pupillary examination (includes pharmacological testing as applicable)
          b.Detailed extraocular motility examination
          c.Ocular alignment testing
          d.Partial or complete neurological examination
          e.Detailed examination of the fundus
          f. Analysis of formal visual field test(s)
          g.Analysis of pertinent diagnostic imaging studies
      2.A241 is only eligible for payment to an ophthalmologist with fellowship training in Neuro-
        ophthalmology.
      3.A241 is only eligible for payment for the assessment of a patient with a neuro-
        ophthalmological disorder.
      4.This service is limited to one per patient, per physician, per 24 month period.
      [Commentary:
      In circumstances where a neuro-ophthalmologist renders an assessment service to a patient
      who is not referred for a neuro-ophthalmology assessment or, where the patient does not have
      a neuro-ophthalmological disorder, see general listings.]

Master, record 133. Record Layout PDF, page 1.

A24120260401999999990000000000000000000000000015545000000000000000000000000

Auxiliary master fields are preserved as raw scaled values. The linked layout calls them zero-filled, but this edition contains non-zero values. They are not presented as final dollar fees or PDF units.