1What Is the A931 OHIP Code?
What is the A931 Billing Code?
The A931 billing code is utilized by fellowship-trained ophthalmologists in Ontario to bill for assessments of uveitis and ocular inflammatory diseases as requested by optometrists. This code is essential for cases where an optometrist identifies anterior chamber inflammation or a suspicious posterior segment change and refers the patient to a specialist.
Understanding the distinction between a typical referral and these optometrist-requested assessments is crucial, as this code applies only when specific clinical findings warrant referral. Without meticulous documentation and adherence to eligibility conditions, physicians may miss opportunities to utilize A931 appropriately.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A935 | Special surgical consultation | Fee per service | Consultations requiring surgical expertise. |
| C935 | Special surgical consultation | Fee per service | Consultations requiring surgical expertise. |
| A231 | Neuro-ophthalmology consultation | Fee per service | Assessment of neuro-ophthalmological conditions. |
| A235 | Consultation | Fee per service | General ophthalmology consultation services. |
3Eligibility Requirements
Eligibility Requirements
To bill using the A931 code, the following criteria must be met:
- Provider Qualifications: Only ophthalmologists with fellowship training in uveitis and ocular inflammatory diseases are eligible for this payment.
- Patient Condition: The patient must be assessed for uveitis, ocular inflammatory, or orbital inflammatory disorder.
- Documentation Requirements: The examination must include:
- A dilated examination of the fundus.
- Accurate recording of the start and end times of the consultation in the patient's permanent medical record.
4What Your Clinical Note Must Show
Ensure the following components are recorded:
- Dilated examination of the fundus
- Start and end time of the assessment
5Weak vs. Strong Note Examples
The strong note provides detailed clinical observations, reflects meticulous documentation, and demonstrates compliance with billing requirements, unlike the weak note.
Patient referred with anterior chamber inflammation, examined.
Patient referred by optometrist with anterior chamber inflammation and suspected posterior segment change.
Completed dilated fundus examination revealing further inflammation.
Assessment started at 10:00 AM and concluded at 10:45 AM.
- Optometrist referral noted
- Dilated fundus examination
- Exact start and end times documented
