G813 – Corneal pachymetry, professional component
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
Corneal pachymetry – measurement of corneal thickness by any method for the purpose of identifying patients at risk for glaucoma on the basis of suspicious optic nerve and/or visual field testing and/or elevated intraocular pressure, and/or family history.
When to Use
- Use G813 when establishing a baseline corneal thickness for a patient with ocular hypertension to determine if the measured intraocular pressure requires adjustment.
- Apply this code when assessing a patient with a suspicious optic nerve head appearance or abnormal visual field results where corneal thickness is needed to stratify glaucoma risk.
Common Pitfalls
- Billing G813 for routine refractive surgery evaluations or pre-operative LASIK assessments will result in an audit rejection as it is strictly limited to glaucoma risk assessment.
- Submitting a second claim for G813 will be automatically rejected by the Ministry because the code is strictly limited to one service per patient per lifetime.
Billing Tips
- Ensure the clinical record explicitly links the pachymetry measurement to the glaucoma risk assessment to satisfy the specific diagnostic requirement of the Schedule of Benefits.
Effective: April 1, 2025
J. Diagnostic and Therapeutic Procedures
DIAGNOSTIC AND THERAPEUTIC PROCEDURES
Diagnostic
Diagnostic and Therapeutic Procedures
This service is limited to one per patient per lifetime. Services in excess of this limit, or rendered for any purpose other than identifying patients at risk for glaucoma, are not insured services.
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