N.J. Admin. Code § 10:62-1.2

Current through Register Vol. 56, No. 21, November 4, 2024
Section 10:62-1.2 - Definitions

The following words and terms, when used in this subchapter, shall have the following meanings unless the context clearly indicates otherwise:

"Clinical laboratory services" means professional and technical laboratory services performed by a clinical laboratory certified by CMS in accordance with the Federal Clinical Laboratory Improvement Act (CLIA), 42 U.S.C. § 263a and ordered by a physician or other licensed practitioner, within the scope of his or her practice, as defined by the laws of the State of New Jersey and/or of the state in which the practitioner practices.

"CMS" means the Federal Centers for Medicare and Medicaid Services.

"Low vision" means reduced visual acuity and/or abnormal visual fields from a disorder in the visual system.

"Low vision client" means an individual with an eye disorder, which reduces visual performance and cannot be corrected by conventional methods.

"Low vision follow-up examination" means examinations provided to clients with aids, to monitor progress and problems.

"Low vision service" means a series of comprehensive tests, evaluations, and multidisciplinary referrals provided for the low vision patient, which has as its objective a prescription of low vision aids and instruction/training programs to enhance the low vision patient's performance.

"National Plan and Provider Enumerations System (NPPES)" means the system tinat assigns a provider a National Provider Identifier (NPI), maintains and updates information about health care providers with NPIs, and disseminates the NPI Registry and NPPES Downloadable File. The NPI Registry is an online query system that allows users to search for a health care provider's information.

"National Provider Identifier (NPI)" means a national identifier issued to healthcare practitioners by the National Plan and Provider Enumeration System (NPPES).

"Ophthalmologist" means a fully licensed medical doctor who has been recognized by the New Jersey Medicaid/NJ FamilyCare fee-for-service programs as a specialist in ophthalmology.

"Optometrist" means any person who is licensed by the New Jersey State Board of Optometry to engage in the practice of optometry, or licensed to engage in the practice of optometry in the state in which he or she performs such functions.

"Practitioner" means a licensed ophthalmologist or optometrist, acting within the scope of licensure.

"Taxonomy code" means a code that describes the provider or organization's type, classification, and the area of specialization.

"Transfer" means the relinquishing of responsibility for the continuing care of the beneficiary by one practitioner and the assumption of such responsibility by another practitioner.

N.J. Admin. Code § 10:62-1.2

Amended by 49 N.J.R. 2279(b), effective 7/17/2017
Amended by 56 N.J.R. 2079(c), effective 10/21/2024