A230 – Orthoptic assessment
OHIP General Listings Code — CONSULTATIONS AND VISITS · Schedule of Benefits
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.
When to Use
- Bill A230 when an ophthalmologist personally performs and interprets a comprehensive orthoptic assessment, including quantitative measurements of all cardinal positions of gaze and sensory testing for binocular vision, cyclodeviation, and retinal correspondence.
- Use A230 for follow-up assessments of strabismus or amblyopia where detailed quantitative measurements and sensory testing are required, differentiating it from simpler follow-up visit codes like A007.
Common Pitfalls
- Claims for A230 will be rejected if the orthoptic assessment is performed by a certified orthoptist; in such cases, G814 is the appropriate code.
- Failure to document quantitative measurements for all cardinal positions of gaze and specific sensory testing results (binocular vision, cyclodeviation, retinal correspondence) in the patient's chart is a common reason for audits and claim reversals.
- Billing A230 when the ophthalmologist only interprets results from an orthoptic assessment performed by another provider, without personally conducting the examination.
Billing Tips
- Ensure the patient's chart clearly details the quantitative measurements for each of the six cardinal positions of gaze and the findings from the sensory tests for binocular vision, cyclodeviation, and retinal correspondence.
- A230 can be billed in conjunction with an ophthalmology consultation or visit code (e.g., A155) if the consultation and the orthoptic assessment are distinct services performed on the same day.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Ophthalmology
Assessment
The assessment must include quantitative measurement of all cardinal positions of gaze (straight ahead, left, right, up, down, tilt right and tilt left).
The assessment must include sensory testing for binocular vision suppression, cyclodeviation, and retinal correspondence.
The service must be rendered personally and interpreted personally by the physician.
Results and measurements must be documented in the patient’s permanent medical record.
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.
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