Codes for Medically Necessary Contact Lenses

Keratoconus, unspecified H18.601—H18.629 Keratoconjunctivitis sicca, not specified as Sjögren’s H16.22 Keratoconus, stable H18.611—H18.619 Keratoconus, unstable H18.621—H18.629 Keratomalacia H18.441—H18.449 Lagophthalmos H02.201—H02.209 Leukocoria H44.53 Mydriasis (Persistent) H57.04 Other corneal scars and opacities H17.89

  Contact, Keratoconus

Report of Vision Examination (DL 62)

Keratoconus Aphakia Pseudophakia Post. Caps. Opac. RETINAL/OPTIC NERVE R L Diabetic Retinopathy Macular Degeneration Glaucoma Retinal Detachment Retinitis Pigmentosa Retinal Damage (CRVO, PRP etc.) VISUAL FIELDS R L Decreased Peripheral Vision Hemianopia Quadrantanopia Decreased Peripheral Vision. ...

  Report, Examination, Vision, Keratoconus, Report of vision examination

OTIP Health Claims Extended Health Benefits Claim PO Box ...

t Were contact lenses prescribed for severe corneal astigmatism, keratoconus or aphakia? Yes No t Can visual acuity be improved at least two lines on the Snellen chart over the best possible vision with glasses? Yes No t Could visual acuity be improved up to the 20/40 level by glasses? Yes No Section ...

  Keratoconus

Appendix A: Medical Considerations for Admissions

• Many chronic eye diseases/conditions such as keratoconus, glaucoma, optic atrophy, uveitis and retinal degenerations are disqualifying. • Procedures to change the refraction (Corneal Refractive Surgery) performed with the excimer laser, including but not limited to photorefractive keratectomy, laser epithelial keratomileusis, and laser-

  Medical, Admission, Appendix, Considerations, Appendix a, Keratoconus, Medical considerations for admissions

Common Optometry Abbreviations

Additional Common Optometry Abbreviations A or Acc ..... accommodation AC ..... anterior chamber AC/A ..... accommodative