A251

PDF page 289 / A161

CONSULTATIONS AND VISITS
 OPHTHALMOLOGY (23)
    b. provision of appropriate information to the patient’s health care team regarding the patient’s
       vision to allow them to better prepare both general and academic plans; and
         c. reporting the findings, opinions or recommendations in writing to other health care team
            members regarding this evaluation and future planning.
   A251 Special ophthalmologic assessment.......................................  125.80
       Payment rules:
       1.No other assessment or consultation is eligible for payment when rendered by the same
         physician to the same patient the same day as A251.
          2.This service is limited to a maximum of 2 services per patient per physician per 12 month
            period.
          Medical record requirements:
          1.The start/stop time of the service must be documented in the patient’s medical record or the
            amount payable for the service will be reduced to a lesser fee.
          2.A statement of the medical condition and how it limits the patient’s ability to participate in the
            assessment with the physician must be documented in the patient’s medical record or the
            amount payable for the service will be reduced to a lesser fee.
          3.A copy of the letter to other health care team members must be maintained in the patient’s
            medical record or the service will be reduced to a lesser fee.
          [Commentary:
          1.Examples of medical conditions that may qualify for A251 include certain chromosomal
            abnormalities, autism, cerebral palsy etc. or evaluation of children/infants with low vision
            associated with or resulting in developmental delay.
          2.Unless otherwise specified in the Schedule, the calculation of time for A256 and A251
            excludes (1) time devoted to any other service or procedure for which an amount is payable
            in addition to the assessment and (2) non-patient-facing time such as such as time spent
            reviewing charts, imaging, or documentation, etc.]

Master, record 139. Record Layout PDF, page 1.

A25120260401999999990000000000000000000000000012580000000000000000000000000

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.