Clinic: Medicare Billing Codes Flashcards
10910
Adults <65yo. Full consult > 15 min
10911
Adults >65yo. Full consult >15 min
10912
Any age. If significant change of visual function requiring comprehensive reassessment (1st course of attn). >15 min
significant change includes:
- vision or visual acuity of 2 lines (0.2 10gMAR) or more (corrected or uncorrected)
- visual fields or previously undetected field loss
- binocular vision
- contrast sensitivity or previously undetected contrast sensitivity loss
Changes must be documented on the patient’s record card.
10913
New signs or symptoms unrelated to earlier course of attn, requiring comprehensive reassessment. (1st course of attn). >15min
10914
Progressive disorder requiring comprehensive reassessment. 1st attn. Must give evidence of condition with copy or excerpt of px’s file. >15min
10915
Diabetes px (confirmed dx). 1st attn. >15 min
10916
Adult < 15 min.
10917
Professional attendance of > 15 minutes in duration, being the first in a course of attention if the patient has attended another optometrist for an attendance to which this item or item 10905, 10910, 10911, 10912, 10913, 10914 or 10915 applies, or to which old item 10900 applied:
(a) for a patient who is less than 65 years of age-within the previous 36 months; or
(b) for a patient who is at least 65 years or age-within the previous 12 months
10918
2nd attn/subsequent consult [NOT related to CLs fitting/paediatric]
Cannot be billed with any digital imaging or to discuss imaging results
10943
Paeds for BV dysfunction (b/w 3-14yo)
10944
Removal of FB (complete including removal of rust ring. If incomplete, charge 10916)
10945/46
Telehealth <15 min > 15 min
10947/48
Aged care telehealth <15 min > 15 min
10905
1st attn. Px was referred here from another optom not associated with the optom patient is referred to
10921
Contact lens prescription/fitting consult for patients with Myopia >/=5D SPE in at least one eye
10922
Contact lens prescription/fitting consult for patients with manifest hyperopia >/=5D SPE in at least one eye
10923
Contact lens prescription/fitting consult for patients with astigmatism >/= 3D
10924
Contact lens prescription/fitting consult for patients with keratometry confirmed irregular astigmatism in either eye, if max VA with specs is worse than 6/12 and if CL acuity improves on that by at least one line/0.1 logMAR
10925
Contact lens prescription/fitting consult for patients with anisometropia of >/= 3D (difference between spherical equivalents)
10926
Contact lens prescription/fitting consult for patients with VA <6/30 in both eyes, where CL prescribing is part of a telescopic system
10927
patients for whom a wholly or segmentally opaque contact lens is prescribed for the alleviation of dazzle, distortion or diplopia
caused by:
(i) pathologjcal mydriasis; or
(ii) aniridia; or
(iii) coloboma of the iris; or
(iv) pupillary malformation or distortion; or
(v) significant ocular deformity or corneal opacity
10928
CLs for patients who, by reason of physical deformity, are unable to wear spectacles
10929
patients who have a medical or optical condition (other than myopia, hyperopia, astigmatism, anisometropia or a condition
to which item 10926, 10927 or 10928 applies) requiring the use of a contact lens for correction, where the condition is
specified on the patient’s account
10930
All professional attendances regarded as a single service in a single course of attention involving the prescription and fitting of
contact lenses where the patient meets the requirements of an item in the range 10921-10929 and requires a change in contact
lens material or basic lens parameters, other than a simple power change, because of a structural or functional change in
the eye or an allergic response within 36 months ofthe fitting of a contact lens covered by item 10921 to 10929
