Tariffs 2017 - Optimum

1 Tariffs 2017 . SERIES 1000 - PROFESSIONAL FEES Per Eye Indicates that the fee is "Per Eye". If performed on both eyes, charge 2 x Can charge in isolation Indicates that the procedure can be charged without Effective Date: 1st January 2017 Version: 2017_1_1. doing an Eye Examination (11001/11081). Legend used in CHANGE* Column: Additional to 11001/11081. Indicates that the procedure can be charged in addition to a regular Eye N = NEW X = DELETED Examination (11001/11081). optometric EXAMINATIONS. The purpose of the optometric Examination is to determine the status of a patient's visual system or to refer to the appropriate health care professional where necessary. Code Change Description RVU Tariff 11001 1 optometric Examination 11081 1 optometric Examination and Visual Field Screening 11021 1 optometric Re-Examination within six months of 11001/11081 Consultation (15 minutes) without performing an optometric 11041 1 Examination.

2 DIAGNOSTIC PROCEDURES. Diagnostic procedures are done and charged in addition to an optometric Examination (11001 to 11041). These are therefore additional procedures based on findings arising out of the optometric Examination. 11303 1 Cycloplegic Refraction 11323 1 Preferential Looking (Infants < Two Years) 11346 1 Corneal Topography 11356 1 Gonioscopy 11366 1 Dilated Fundus Examination / BIO 11423 1 Visual Field - Evaluation 11443 1 Visual Field - Threshold Testing 11246 1 Colour Vision Evaluation 11265 1 Contrast Sensitivity Evaluation 11283 1 Lacrimal System Evaluation 11604 1 Photography of Anterior Segment 11624 1 Photography of Fundus 11644 1 Diagnostic and Photographic Materials N/A. 11702 1 Pachymetry 11802 1 Optical Coherence Tomography (OCT) 11902 1 Visual Evoked Potentials (VEP) - Unilateral 11904 1 Visual Evoked Potentials (VEP) - Bilateral PROCEDURES DONE IN ISOLATION.

3 These are generally follow-up procedures or specific requests by patients or medical practitioners. The clinical rule that applies is that these codes may be listed as a professional fee in isolation but may not be charged in conjunction with optometric Examinations. Please note that the sum total charged for such procedures done in isolation may not be more than an optometric Examination (11001). 11141 1 Refractive Status Evaluation 11161 1 Ocular Pathology Screening 11183 1 Keratometry 11202 1 Tonometry (Non-contact) 11212 1 Tonometry (Aplanation) 11221 1 Colour Vision Screening 11402 1 Visual Field - Screening DISPENSING FEE (per pair). 11501 1 Dispensing Fee - Single Vision 11521 1 Dispensing Fee - Bifocals 11541 1 Dispensing Fee - Varifocals SERVICES OUTSIDE OF REGULAR OFFICE HOURS.

4 11707 1 After Hours or Away from Practice Visit . 11729 1 Broken Appointments optometric SCREENING SERVICES. 11809 1 Screening School (per hour) 11829 1 Screening Industrial (per hour) Professional fees - Page 1 of 146. Tariffs 2017 . CONTACT LENS PROFESSIONAL FEES. PLEASE NOTE THAT THE COMPLETE CONTACT LENS FITTING FEE (Includes Dispensing & 6 months aftercare) HAS BEEN DISCONTINUED. Contact lens fees are now specified and coded per visit. The terms Basic; Complex and Advanced are defined by factors such as time; skill; degree of difficulty and case type: Basic Up to 4 visits may apply for an initial (first time) fit. Myopia < Hyperopia < + Low Astigmatism. Complex Up to 6 visits may apply for an initial (first time) fit. Myopia > Hyperopia > + Extended Wear & Toric Lenses Advanced Up to 8 visits may apply for an initial (first time) Bifocal / multifocal; Bitoric; Haptic; Post PKP; Post Lasik; Post RK; Reverse Geometry / Orthokeratology and Keratoconus.

5 Therapeutic Therapeutic Contact lens procedures are used for conditions where functional vision cannot be obtained with spectacle lenses CONTACT LENS PROCEDURES. Code Description RVU. 12012 1 C Lens Consultation Basic - per 30 minutes 12032 1 C Lens Consultation Complex - per 30 minutes 12052 1 C Lens Consultation Advanced - per 30 minutes 12062 1 C Lens Consultation - Therapeutic - per 30 minutes 12112 1 C Lens follow-up Examination/Basic Case - per 30 minutes 12132 1 C Lens follow-up Examination/Complex Case - per 30 minutes 12152 1 C Lens follow-up Examination/Advanced Case - per 30 minutes 12162 1 C Lens Follow-up Therapeutic - per 30 minutes 12503 1 C Lens Related Problems Assessment - Monocular 12523 1 C Lens Related Problems Assessment- Binocular 12533 1 C Lens Instruction 12072 1 C Lens Dispensing and/or Assessment Note: Code 12072 refers to OTC dispensing of contact lenses.

6 Either re-ordered or from other practices BINOCULAR VISION/ORTHOPTICS. These evaluations are done in addition to an optometric Examination. Special examination techniques apply to this area of expertise. The differentiating factor regarding Simple and Complex cases is by default: Complex cases have to do with Eccentric Fixation and / or Anomalous Retinal Correspondence. 13003 1 Binocular Instability Evaluation - Simple Case 13023 1 Binocular Instability Evaluation - Complex Case VISUALLY RELATED DISORDERS. 13105 1 Visually Related Learning Disorders Evaluation 13125 1 Eye Movements Evaluation ( Visigraph) COLORIMETRY CODES. 13509 1 Reading Rate- screening 13529 1 Reading Ortho-Didactical skills evaluation 13549 1 Colorimetry Intuitive - evaluation VISUAL THERAPY/ ORTHOPTICS TRAINING.

7 13403 1 Vision Training - Home Therapy Instruction 13423 1 Vision Training - Individual (per 15 minutes) 13445 1 Vision Training - Individual (per 30 minutes) 13463 1 Vision Training - Group per Patient (per 15 minutes) 13489 1 Vision Training - Away From Practice (add to 13423 or 13463) N/A. LOW VISION. The Low Vision Assessment examination is performed in addition to a visual examination where patients present with visual acuity that is worse than 6/18 or visual fields that are severely restricted. The reason being that such a visual examination is performed with a different approach to the conventional visual examination (both psychologically and clinically). In addition to the low vision assessment further Procedures done in isolation are necessary in order to determine what device and training is required as treatment.

8 RVU. LOW VISION ASSESSMENT& TRAINING (per half hour). 16013 1 Low Vision Assessment per 30 mins 16073 1 Low Vision Training per 30 mins SPORTS VISION. SPORTS VISION - IN OFFICES PROCEDURES. RVU. 14008 1 Sports Vision Individual Screening 14218 1 Sports Vision Individual Evaluation 14238 1 Sports Vision Individual Training (per 15 minutes) 14268 1 Sports Vision Group Screening 14278 1 Sports Vision Group Evaluation 14288 1 Sports Vision Group Training (per 15 minutes) SPORTS VISION - PROCEDURES DONE IN THE FIELD. 14309 1 Sports Vision Individual Screening 14319 1 Sports Vision Individual Evaluation 14329 1 Sports Vision Individual Training (per 15 minutes) 14369 1 Sports Vision Group Screening 14379 1 Sports Vision Group Evaluation 14389 1 Sports Vision Group Training (per 15 minutes) REPORTS etc 19001 1 Report at request of Medical Aid.

9 19021 1 Professional fees - Page 2 of 146. Report at Patient's request (arising from Series 11001) Tariffs 2017 . SERIES 2000 - CONTACT LENS MATERIALS. Effective Date: 1st January 2017 Version: 2017_1_1. N = NEW X = DELETE. Code Change Description Pack Tariff CONTACT LENS SOLUTIONS. 23907 Contact Lens Solutions 23919 Contact Lens Accessories Note that pricing of contact lenses is no longer specified by the various categories, rather as a global fee without specifying type of material or design of lens and is marked up from the manufacturer price accordingly. HARD CONTACT LENS CODES (per lens). 24022 Hard Contact Lens 24024 Rigid Scleral Contact lens ADDITIONAL HARD CONTACT LENS CODES (per lens). 25412 Fenestration Hard Lens (per hole). 25512 Truncation Hard Lens 24202 Bifocal Hard Lens 26012 Laboratory Service / Modification / Polish 26115 Analysis of Hard Lens CONVENTIONAL SOFT CONTACT LENSES.

10 Contact Lens Laboratory of SA. 27146 Kerasoft IC 77% 1 Vial 27147 Kerasoft 2 49% 1 Vial 27365 BIO-Colours 38% Conventional Custom-Colours (Sphere) 1 Vial 27368 BIO-Colours 38% Conventional Custom-Colours (Toric) 1 Vial 27327 CLL HEMA (up to 60%) 1 Vial 27329 CLL HWC (higher than 60%) 1 Vial 27145 CLL Contaflex 38% Prosthetic 1 Vial 27150 CLL Soft Haptic 38% Prosthetic 1 Vial 27155 CLL Dark Brown Iris Black Pupil Prosthetic 1 Vial 27165 CLL Field Eyes (sports tint) 1 Vial 27170 CLL Enhancing Iris Tint 1 Vial 27175 CLL Hand Painted Theatricals 1 Vial 27180 CLL Photo-phobic 1 Vial 27185 CLL Albino Iris 1 Vial 27341 Soflex Soft K 67% (Hydrogel) - For Keratoconus 1 Vial 27353 Soflex Soft K 67% RG (Hydrogel) - For Keratoconus 1 Vial 27343 Soflex Soft K 67% Toric (Hydrogel)