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A110

A110Periodic oculo-visual assessment - aged 19 years and below

OHIP General Listings Code — CONSULTATIONS AND VISITS · Schedule of Benefits

A periodic oculo-visual assessment is an examination of the eye and vision system rendered primarily to determine if a patient has a simple refractive error (defined as myopia, hypermetropia, presbyopia, anisometropia or astigmatism) for patients aged 19 or less.

When to Use

  • Bill A110 for a child aged 10 presenting for their first comprehensive eye exam to check for myopia or astigmatism.
  • Use A110 for a 17-year-old who has not had a periodic oculo-visual assessment in the past 12 months and requires a refraction check.
  • A110 is appropriate for a 5-year-old with a family history of strabismus, undergoing a routine visual assessment including motility testing.

Common Pitfalls

  • Billing A110 for a patient aged 20 or older; these patients require A115.
  • Submitting A110 more than once within a 12-month period for the same patient, even if the assessment was performed by different physicians or an optometrist.
  • Billing A110 on the same day as another insured service by the same physician (excluding ophthalmologists); use a different assessment code if necessary and appropriate.

Billing Tips

  • Ensure all required components, including history, visual acuity, slit lamp exam, ophthalmoscopy, and tonometry, are documented to support the A110 claim.
  • If a patient requires a re-assessment after an A110, bill a lesser assessment code (e.g., A007) with diagnostic code 367, not another A110.
Provider Fee$48.90

Effective: April 1, 2025

Category

A. Consultations and Visits

Subcategory

CONSULTATIONS AND VISITS

Service Type

Oculo-visual assessment

Code Classes

Assessment

Age Restriction

aged 19 years and below

Services in excess of the 12-month limit are not insured services.

Services to patients aged 20 to 64 are not insured services under this code.

Re-assessment following a periodic oculo-visual assessment is to be claimed using a lesser assessment fee code and diagnostic code 367.

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