Washington Administrative Code › Title 182 - Health Care Authority › WASHINGTON APPLE HEALTH › Chapter 182-544 - Vision care › VISION CARE - CLIENTS TWENTY YEARS OF AGE AND YOUNGER › Section 182-544-0050 - Vision care - Definitions

Current through Register Vol. 24-14, July 15, 2024
The following definitions and those found in chapter
					 182-500 WAC apply to this chapter. Unless otherwise defined in this chapter,
					 medical terms are used as commonly defined within the scope of professional
					 medical practice in the state of Washington.
"Blindness"
- A diagnosis of visual acuity for
					 distance vision of twenty/two hundred or worse in the better eye with best
					 correction or a limitation of the client's visual field (widest diameter)
					 subtending an angle of less than twenty degrees from central.
"Conventional soft contact lenses"
or
"rigid gas permeable contact lenses"
- FDA-approved contact lenses
					 that do not have a scheduled replacement (discard and replace with new
					 contacts) plan. The soft lenses usually last one year, and the rigid gas
					 permeable lenses usually last two years. Although some of these lenses are
					 designed for extended wear, the medicaid agency generally approves only those
					 lenses that are designed to be worn as daily wear (remove at night).
"Disposable contact lenses"
- FDA-approved
					 contact lenses that have a planned replacement schedule (e.g., daily, every two
					 weeks, monthly, quarterly). The contacts are then discarded and replaced with
					 new ones as scheduled. Although many of these lenses are designed for extended
					 wear, the agency generally approves only those lenses that are designed to be
					 worn as daily wear (remove at night).
"Expedited prior authorization"
- A form of
					 authorization used by the provider to certify that the agency-published
					 clinical criteria for a specific vision care service(s) have been met.
"Extended wear soft contacts"
- Contact lenses
					 that are designed to be worn for longer periods than daily wear (remove at
					 night) lenses. These can be conventional soft contact lenses or disposable
					 contact lenses designed to be worn for several days and nights before
					 removal.
"Hardware"
- Eyeglass frames and lenses and
					 contact lenses.
"Prior authorization"
- A form of
					 authorization used by the provider to obtain the agency's written approval for
					 a specific vision care service(s). The agency's approval is based on medical
					 necessity and must be received before the service(s) are provided to clients as
					 a precondition for payment.
"Specialty contact lens design"
- Custom
					 contact lenses that have a more complex design than a standard spherical lens.
					 These specialty contact lenses (e.g., lenticular, aspheric, or myodisc) are
					 designed for the treatment of specific disease processes, such as keratoconus,
					 or are required due to high refractive errors. This definition of specialty
					 contact lens does not include lenses used for surgical implantation.
"Stable visual condition"
- A client's eye
					 condition has no acute disease or injury; or the client has reached a point
					 after any acute disease or injury where the variation in need for refractive
					 correction has diminished or steadied. The client's vision condition has
					 stabilized to the extent that eyeglasses or contact lenses are appropriate and
					 that any prescription for refractive correction is likely to be sufficient for
					 one year or more.
"Visual field exams or testing"
- A process to
					 determine defects in the field of vision and test the function of the retina,
					 optic nerve and optic pathways. The process may include simple confrontation to
					 increasingly complex studies with sophisticated equipment.
11-14-075, recodified as §
												182-544-0050, filed 6/30/11,
						effective 7/1/11. Statutory Authority:
						RCW
						74.08.090,
						74.09.510,
						74.09.520. 08-14-052, §
						388-544-0050, filed 6/24/08, effective 7/25/08. Statutory Authority:
						RCW
						74.08.090,
						74.09.510,
						74.09.520 and
						42 C.F.R.
						440.120 and
						440.225. 05-13-038, §
						388-544-0050, filed 6/6/05, effective 7/7/05. Statutory Authority:
						RCW
						74.08.090,
						74.09.510 and
						74.09.520. 01-01-010, §
						388-544-0050, filed 12/6/00, effective
						1/6/01.