All codes
G463
G463 – Hydrophilic Bandage lens fitting
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
This service covers the fitting of a hydrophilic bandage lens.
When to Use
- Use G463 when applying a bandage contact lens to treat corneal epithelial defects or recurrent erosions that require a therapeutic protective barrier.
- Apply this code for post-operative management where a bandage lens is medically necessary to facilitate healing following ocular surface procedures.
Common Pitfalls
- Do not bill G463 for routine refractive contact lens fitting, as this is considered a non-insured service and will lead to claim rejection.
- Avoid billing G463 in conjunction with G423 or G424 for the same eye on the same day, as these codes are intended for distinct diagnostic or therapeutic contact lens services.
Billing Tips
- Ensure the clinical record explicitly justifies the medical necessity of the bandage lens, such as documenting the specific corneal pathology, to withstand potential Ministry audits.
Provider Fee$90.30
Effective: April 1, 2025
Category
J. Diagnostic and Therapeutic Procedures
Subcategory
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Service Type
Procedure
Code Classes
Diagnostic and Therapeutic Procedures
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