A252

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Initial vision rehabilitation assessment
          Initial vision rehabilitation assessment by an ophthalmologist of a patient with either low visual
          acuity, visual field defect, or significant oculomotor dysfunction subject to the conditions below.
          This service is only payable when a minimum of four (4) of the following eight (8) listed
          components are rendered during the same visit:
          1.Cognitive assessment to determine capacity to cooperate with assessment and treatment.
          2.Assessment of residual visual function to include at least two of the following tests: visual
            acuity tested with ETDRS charts, macular perimetry, contrast sensitivity tested at 5 spatial
            frequencies and fixation instability.
          3.Assessment of eccentric preferred retinal loci.
          4.Assessment of near functional visual acuity with ETDRS charts.
          5.Assessment of reading skills.
          [Commentary:
          For example, using MNRead or Colenbrander charts.]
          6.Prescribing of low vision devices aimed to improve residual visual function.
          7.Preparation of a vision rehabilitation plan and/or discussion of the plan with the patient.
          8.Supervised training of the patient, in accordance with recognized programs, for use of low
            vision devices and/or training for rehabilitation of skills dependent on vision.
   A252 Initial vision rehabilitation assessment....................................       251.65
     Follow-up vision rehabilitation assessment
       This service is only payable when a minimum of three (3) of the eight (8) components listed
       above are rendered in the same visit.
   A254 Follow-up vision rehabilitation assessment ............................     125.80
       Payment rules:
       For A252 and A254:
          1.No other assessment or consultation is eligible for payment when rendered by the same
            physician to the same patient the same day as A252 or A254.
          2.A252 is limited to two (2) per patient per five (5) year period per physician.
          3.A254 is only payable when the patient has received an A252.

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CONSULTATIONS AND VISITS
OPHTHALMOLOGY (23)
    4.A254 is limited to ten (10) per patient per five (5) year period from the date of the most recent
      A252.
    5.If the minimum required number of components for A252 or A254 are not rendered, the
      amount payable for the service will be reduced to a lesser fee.
      [Commentary:
      Diagnostic services (e.g. visual field testing), when rendered, are eligible for payment with
      these services.]

Master, record 140. Record Layout PDF, page 1.

A25220260401999999990000000000000000000000000025165000000000000000000000000

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.