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PROGRAM OF CHOICE (POC) 14 – VISION (EYE) CARE BENEFIT GRID UPDATE - CORRECTION NOTICE – EFFECTIVE FEBRUARY 1, 2012 Rev 1.0

PROGRAM OF CHOICE (POC) 14 – VISION (EYE) CARE BENEFIT GRID UPDATE - CORRECTION NOTICE – EFFECTIVE FEBRUARY 1, 2012 Rev 1.0

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PROGRAM OF CHOICE (POC) 14 – VISION (EYE) CARE BENEFIT GRID UPDATE - CORRECTION NOTICE – EFFECTIVE FEBRUARY 1, 2012 Rev 1.0
PROGRAM OF CHOICE (POC) 14 – VISION (EYE) CARE BENEFIT GRID UPDATE - CORRECTION NOTICE – EFFECTIVE FEBRUARY 1, 2012 Rev 1.0

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Published by: Canadian_Veterans_Ad on Feb 25, 2012
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05/13/2014

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VETERANS AFFAIRS CANADA (VAC)PROGRAM OF CHOICE (POC) 14 – VISION (EYE) CARE*** CORRECTION NOTICE ***
February 2012Veterans Affairs Canada (VAC) recently implemented changes to the Benefit Grid for Program ofChoice (POC) 14 – Vision (Eye) Care. These changes were communicated via a four-page bulletinmailed to you.Attached to this correction notice is a revised version of the entire bulletin, including the revisionsdescribed below.
The new benefit codes 604126, 604128 and 600312 created February 1, 2012 will beterminated effective February 29, 2012. These codes were created in error. Please continueusing 604127 and 604129 in lieu of 604126 and 604128.604127Lens Benefit - Left Lens(Corrective)Pre-authorization Required: NoPrescriber: O,OPFrequency: 1/2 CY604129Lens Benefit - RightLens (Corrective)Pre-authorization Required: NoPrescriber: O,OPFrequency: 1/2 CY
Benefit code 600313 is now listed as:600313 Lenses ProgressivePre-authorization Required: NoPrescriber: O,OPFrequency: 2/2 CYDollar Limit: $108.99 (per lens)
The benefit code 602561, Contact Lens Replacement no longer requires pre-authorization.
The dollar limit was removed from benefit code 600212, Lens Coating – Photochromatic.All other information in the previous bulletin remains the same. Bulletins can be viewed electronicallyby visiting the Medavie Blue Cross website at www.medavie.bluecross.ca and clicking on the HealthProfessionals link, then the Bulletins link under Additional Health Care Providers.Should you have any questions, please contact your regional Blue Cross office Provider Inquiry Linetoll free at 1-888-261-4033.
 
2 of 4
NEW
 
BENEFIT
 
CODES
 
 –
 
EFFECTIVE
 
FEBRUARY
 
1,
 
2012
 
(ALL
 
PROVINCES)C
ODE
D
ESCRIPTION
C
OMMENTS
 
600221 GDX Scanning Laser PolarimetryPre-authorization Required: YesFrequency: 1/1 CY600036Heidelberg Retinal Tomography (HRT) forGlaucomaPre-authorization Required: YesFrequency: 1/1 CY600301 PachymetryPre-authorization Required: YesFrequency: 1/2 CY600302 Retinal ImagingPre-authorization Required: YesFrequency: 1/2 CYDollar Limit: $35600303 Therapeutic Exam and Treatment Pre-authorization Required: Yes600034 Ocular Coherence Tomography (OCT) examPre-authorization Required: YesFrequency: 1/1 CY602561 Contact Lens ReplacementPre-authorization Required: NoPrescriber: O,OPFrequency: 4/1 CY600313 Lenses ProgressivePre-authorization Required: NoPrescriber: O,OPFrequency: 2/2 CYDollar Limit: $108.99 (per lens)630111 Exam Intraocular Lenses MasterPre-authorization Required: YesFrequency: 1/2 CY600310 Frames and Lenses (1 set) Special OversizedPre-authorization Required: YesPrescriber: O,OPFrequency: 1/2 CY630100 Exam Dilation Exam for DiabeticsPre-authorization Required: NoPrescriber: No602854Ophthalmic Dispensing Fee – Multifocal/Trifocal/ProgressivePrescriber: NoDollar Limit: $90602562Contact Lens Fitting Procedure/Evaluation – Multifocal/ToricPre-authorization Required: YesPrescriber: NoFrequency: 1/1 CY600212 Lens Coating Photochromatic Prescriber: No
NEW
 
BENEFIT
 
CODE
 
 –
 
ALL
 
PROVINCES
 
EXCEPT
 
THE
 
ATLANTIC
 
PROVINCES
 
WHERE
 
A
 
CODE
 
ALREADY
 
EXISTS
 
FOR
 
THIS
 
BENEFIT
600211Lens Coating – Anti-Reflective/Scratch ResistantCoatingFrequency: 2/2 CY
 
3 of 4
MODIFICATIONS
 
TO
 
EXISTING
 
BENEFITS
 
 –
 
EFFECTIVE
 
FEBRUARY
 
1,
 
2012C
ODE
D
ESCRIPTION
C
OMMENTS
 T
HE FOLLOWING MODIFICATIONS APPLY TO ALL PROVINCES
:
600624 Fees (Vision) Ophthalmoscopy Pre-authorization Required: Yes (added)603070Sunglasses (not-corrective) Including Clip-Ons/ Wrap-AroundsPreauthorization Required: Yes (added)Prescriber: No (removed)Frequency: 1/2 CY (revised)
T
HE FOLLOWING MODIFICATION APPLIES TO
O
NTARIO ONLY
:
600624 Fees (Vision) OphthalmoscopyPre-authorization Required: Yes (added)Dollar Limit: $24.74 (added)
 T
HE FOLLOWING MODIFICATION APPLIES TO ALL PROVINCES EXCEPT THE
A
TLANTIC PROVINCES
(W
HERETHIS IS ALREADY A REQUIREMENT
):
600638 Fees (Vision) Biomicroscopy Pre-authorization Required: Yes (added)
 T
HE FOLLOWING MODIFICATION APPLIES TO ALL PROVINCES EXCEPT THE
A
TLANTIC PROVINCESAND
Q
UEBEC
(
AGREEMENTS IN PLACE
):
604120Lens Coating – Hardened/Impact Resistant -New Frames or LensesDollar Limit: $15 (added)
T
HE FOLLOWING MODIFICATION APPLIES TO ALL PROVINCES EXCEPT THE
A
TLANTIC PROVINCES
(
WHERE THIS IS ALREADY A REQUIREMENT
)
AND
B
RITISH
C
OLUMBIA
:
600427 Fees (Vision) TonometryPre-authorization Required: Yes (added)Dollar Limit: $21.70 (added)
 

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