one of: (a) Full field manual perimetry such as 2 or 3 isopters on Goldman perimeter or equivalent, with spot checks between isopters and kinetic plotting of scotomata; or (b) limited area manual static threshold perimetry such as 2 or 3 half-meridians at 2 degree intervals to 30 degrees from fixation, or 30 to 50 static threshold points in any arrangement; or (c) automated testing at 2 or 3 threshold related luminance levels (such as OCTOPUS program 33 or 34 or equivalent); or (d) automated testing of periphery only (such as OCTOPUS program 41 or equivalent)
All eye examination fees cover both eyes unless otherwise indicated.
Do not bill professional or technical fee separately to the Plan: for institutional information only.
02042 includes 02041.
Fee includes examination of both eyes whether at one time or two separate visits.
Recommended frequency depends on the patient's clinical circumstances but cannot be billed at intervals less than 120 days without written justification.