Visual Fields

Visual field testing (static or kinetic perimetry) is medically necessary for diagnosed glaucoma, suspected glaucoma with specified supporting findings, documented disorders of the optic nerve/retina/visual pathways, certain intracranial vascular or mass events, medication toxicity monitoring (e.g., hydroxychloroquine), unexplained visual loss, significant eye injury, eyelid/orbital conditions affecting fields, and initial evaluation of macular degeneration with central vision ≤20/70. Routine confrontation testing is part of general ophthalmologic care and is not separately billable; pretreatment visual fields are not required for established retinal detachment and are not indicated pre‑cataract extraction in non‑glaucoma patients. Frequency of testing is determined by clinical judgment and disease stage, and claims for unusually frequent testing may be reviewed for medical necessity.

"Visual field testing is medically necessary for a documented diagnosis of glaucoma to monitor stabilization or progression of disease."