G524 – Multi-focal electro-retinography - professional component
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
The professional component of multi-focal electro-retinography, which includes the interpretation and written report. This service is only eligible for payment for the evaluation of disorders of the retina involving high resolution vision function (i.e. cone function). The service includes any pupil dilation and refraction necessary to complete the study. The technical component is billed separately using G852.
When to Use
- Use G524 when interpreting the results of a multi-focal electro-retinography (mfERG) specifically to assess macular or cone-mediated retinal function.
- Use this code when evaluating patients for toxic maculopathy, such as monitoring for hydroxychloroquine retinal toxicity, where high-resolution cone function assessment is required.
Common Pitfalls
- Billing G524 for general retinal screenings or conditions unrelated to cone function, which will trigger audit flags for non-compliance with the 'high resolution vision' requirement.
- Attempting to bill for pupil dilation or refraction separately, as these services are explicitly bundled into the G524 fee.
Billing Tips
- Ensure the technical component G852 is billed alongside G524 to capture the full service, as G524 only covers the professional interpretation and report.
- Maintain a clear written report in the patient record that specifically addresses the cone function findings to justify the medical necessity of the G524 claim.
Effective: April 1, 2025
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Diagnostic
Diagnostic and Therapeutic Procedures
Payment rules:
1. G852 is limited to 4 services per patient per 12 month period.
2. G439 is limited to 2 services per patient per 12 month period.
3. G524 is limited to 2 services per patient per 12 month period.
4. G524 is only eligible for payment for the evaluation of disorders of the retina involving high resolution vision function (i.e. cone function).
5. Electro-retinography includes any pupil dilation and refraction necessary to complete the study.
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