A230

PDF page 284 / A156

CONSULTATIONS AND VISITS
OPHTHALMOLOGY (23)
  Periodic oculo-visual assessment
A237 - aged 19 years and below ...................................................                 59.35
A239 - aged 65 years and above...................................................                  59.35
    Note:
    See General Preamble GP28 for definitions and conditions.
  Major eye examination
A115 Major eye examination (see page A10) ..................................                       53.60
  Orthoptic assessment
    Orthoptic assessment must include quantitative measurement of all cardinal positions of gaze
    (straight ahead, left, right, up, down, tilt right and tilt left), sensory testing for binocular vision
    suppression, cyclodeviation and retinal correspondence. An orthoptic assessment is eligible for
    payment in addition to an ophthalmology consultation or visit.
A230 Orthoptic assessment .............................................................       26.20
    Note:
    A230 is only eligible for payment when all tests described under orthoptic assessment are
    rendered personally and interpreted personally by the physician and results and measurements
    are documented in the patient’s permanent medical record.
     [Commentary:
     If a certified orthoptist is rendering the examination, G814 may be eligible for payment (page
     J94).]

PDF page 508 / J94

DIAGNOSTIC AND THERAPEUTIC PROCEDURES
OPHTHALMOLOGY
                                                                                           Fee
     3. G818 is eligible for payment only for one or more of the following:
        a.hemorrhage or exudate in the macula on clinical examination;
        b.retinal folds/wrinkling on clinical examination;
        c.macular hole/pseudohole on clinical examination;
        d.vision loss not explained by dilated clinical examination findings; or
        e.presence or reasonable suspicion of choroidal neovascular membrane, subretinal fluid or
          cystoid macular edema on clinical examination.
     4. G820 is eligible for payment only for one or more of the following:
        a.suspicion of glaucoma based on optic nerve appearance on dilated clinical examination;
        b.suspicion of glaucoma based on visual field testing;
        c.elevated intraocular pressure; or
        d.history of glaucoma in an immediate family member.
     5. G818, G820, G821, G822 or G823 is only eligible for payment when a consultation or
       assessment has been rendered by the same physician for the same patient in relation to the
       same condition for which OCT is being performed.
     [Commentary:
     For every claim for G818, G820, G822 or G823 there must be a separate consultation or
     assessment claimed by the same physician, but the services do not necessarily have to be
     rendered on the same day.]
     6. G820 is limited to a maximum of two services per patient per 12 month period.
     7. Any combination of G818, G820 or G821 is limited to a maximum of four services per patient
       per 12 month period.
     8. Only one of G818, G820, G821, G822 or G823 is eligible for payment per patient same day.
  Orthoptic examination
   Orthoptic examination must include quantitative measurement of all cardinal positions of gaze
   (straight ahead, left, right, up, down, tilt right and tilt left), sensory testing for binocular vision
   suppression, cyclodeviation, retinal correspondence and interpretation. Orthoptic examination
   is eligible for payment in addition to an ophthalmology consultation or visit. The examination
   must be rendered by an orthoptist who is certified by the Canadian Orthoptic Council and
   employed by the ophthalmologist or a public hospital. The interpretation component of the
   examination must be personally rendered by the ophthalmologist.
G814 Orthoptic examination.............................................................     25.00
   Note:
   G814 is only eligible for payment when all tests described under orthoptic examination are
   rendered and the results and measurements are documented in the patient’s permanent
   medical record.
     [Commentary:
     If the interpreting ophthalmologist is also rendering the examination, the service should be
     claimed as A230.]

Master, record 123. Record Layout PDF, page 1.

A23020260401999999990000000000000000000000000002620000000000000000000000000

Auxiliary master fields are preserved as raw scaled values. The linked layout calls them zero-filled, but this edition contains non-zero values. They are not presented as final dollar fees or PDF units.