A931 – Optometrist-requested assessment (ORA) for uveitis and ocular inflammatory diseases.
OHIP General Listings Code · Schedule of Benefits
Optometrist-requested assessment for uveitis and ocular inflammatory diseases is an assessment in which the ophthalmologist provides all the elements of an Optometrist-Requested Assessment (A253) for a patient with a uveitis, ocular inflammatory or orbital inflammatory disorder.
When to Use
- Bill A931 when an optometrist refers a patient specifically for a complex uveitis assessment, requiring a dilated fundus exam and analysis of inflammatory markers.
- Use A931 when the optometrist's referral letter explicitly states suspicion of an ocular inflammatory disorder, necessitating specialized ophthalmologic evaluation beyond a standard assessment.
Common Pitfalls
- Billing A931 for a patient without a confirmed uveitis, ocular inflammatory, or orbital inflammatory disorder is a common error; use A253 in such cases.
- Failure to retain the optometrist's written referral request in the patient's chart will lead to fee reduction, even if all other documentation is complete.
- Not submitting written findings, opinions, and recommendations to both the referring optometrist and the patient's primary care physician will result in a reduced assessment fee.
Billing Tips
- Ensure the optometrist's written request clearly outlines the suspected uveitis or inflammatory condition to justify the use of A931 over A253.
- Document the dilated fundus examination and the analysis of any laboratory or imaging studies performed as part of the uveitis assessment to meet A931 requirements.
Effective: April 1, 2026
Ophthalmology
Assessment
Must be provided upon the written request of an optometrist because of the complex, obscure, or serious nature of the patient’s problem.
Urgent or emergency requests may be initiated verbally but must be documented in writing.
The ophthalmologist must submit findings, opinions, and recommendations in writing to both the optometrist and the patient’s primary care physician or nurse practitioner (if applicable).
The written request from the optometrist must be retained on the patient’s permanent medical record.
The following must be documented as part of the examination: a. Dilated examination of the fundus; and b. Analysis of laboratory testing, radiological and ocular imaging studies performed for investigation of the patient’s ocular inflammatory disease.
In circumstances where an ophthalmologist with fellowship training in uveitis and ocular inflammatory diseases renders an assessment service to a patient who is not referred for an assessment for a uveitis, ocular or orbital inflammatory disorder or, where the patient does not have a uveitis, ocular or orbital inflammatory disorder, see general listings.
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