N.J. Admin. Code § 10:62-1.5

Current through Register Vol. 56, No. 21, November 4, 2024

Section 10:62-1.5 - Comprehensive eye examination

(a) A comprehensive eye examination may include cycloplegics and a post cycloplegic visit. All findings and data, including positive and negative, shall be clearly recorded. A comprehensive eye examination shall include the following, as a minimum, where possible unless contraindicated:

1. Detailed case history;

2. Complete visual acuity findings;

3. External and internal (ophthalmoscopic) examination including slit lamp;

4. Refraction, objective and subjective;

5. Extra-ocular measurement;

6. Gross visual fields, central and peripheral;

7. Tonometry when indicated for patients under 35; tonometry is mandatory for all patients over 35. The specific method used should be identified and recorded; the finger palpation test is not acceptable;

8. Binocular coordination testing (distance and near), fusion, stereopsis, and color vision;

9. The diagnosis, including, but not limited to, ocular deficiency or deformity, visual or muscular anomaly; and

10. Recommendations.

(b) For reimbursement purposes, a comprehensive eye examination shall include all the criteria of a comprehensive eye examination plus complete Diagnostic Visual Fields.

1. Comprehensive eye examinations with diagnostic fields are not routinely reimbursable for complete comprehensive eye examinations. Patients should be selected for diagnostic field testing based upon history and ophthalmologic findings during the physical examination if optic or motor nerve abnormalities are suspected. Alternatively, if other significant physical findings are present and documented, diagnostic visual field studies may be selectively employed to establish or to confirm the diagnosis and/or the degree of impairment.

2. A comprehensive eye examination with or without diagnostic fields shall be limited to once a year.

N.J. Admin. Code § 10:62-1.5

Amended by 49 N.J.R. 2279(b), effective 7/17/2017

Amended by 56 N.J.R. 2079(c), effective 10/21/2024