G810 – Corneal topography, professional component
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
Corneal topography is the topographical mapping of the cornea. This service is for the purpose of assessing patients with the same indications as those set out for keratometry (G811). The eligible indications are for assessing patients: - a. with irregular astigmatism resulting from scarring due to trauma, herpes simplex keratitis, dystrophies (such as Salzman's and map-dot-fingerprint dystrophy) or other inflammatory disorders; or - b. with keratoconus, pellucid marginal degeneration, keratoglobus, following penetrating keratoplasties or following pterygium excision, or - c. with corneal thinning or ectasia where corneal cross linking is being contemplated or has been performed.
When to Use
- Use G810 for mapping patients with documented keratoconus or pellucid marginal degeneration to monitor progression or surgical candidacy.
- Use G810 for patients with irregular astigmatism caused by corneal scarring from previous herpes simplex keratitis or trauma where standard keratometry (G811) is insufficient.
- Use G810 when assessing corneal thinning or ectasia specifically to determine eligibility for or follow-up after corneal cross-linking procedures.
Common Pitfalls
- Billing G810 for routine refractive error or standard astigmatism without a documented underlying pathology listed in the Schedule of Benefits is a frequent cause of audit recovery.
- Billing both G810 and G811 on the same date of service for the same eye is prohibited as they are mutually exclusive alternatives for the same diagnostic purpose.
- Failing to document the specific corneal dystrophy or inflammatory disorder in the clinical record will result in a rejection if the claim is reviewed.
Billing Tips
- Ensure the clinical note explicitly states the diagnosis (e.g., keratoconus or post-pterygium excision) to justify the use of G810 over a standard eye exam code.
- If performing topography for screening or non-eligible conditions, do not bill OHIP, as these are considered non-insured services.
Effective: April 1, 2025
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Diagnostic
Diagnostic and Therapeutic Procedures
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