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G820 – Optical coherence tomography (OCT) - glaucoma

OHIP Diagnostic and Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits

Optical coherence tomography (OCT) for glaucoma, performed unilaterally or bilaterally. The service is payable when the physician interprets the results and either performs the procedure or supervises its performance. It is insured only for the diagnosis and management of glaucoma when the ophthalmologist is the most responsible physician for the patient's care. This service is not payable for patients younger than 18 years of age or when rendered for preparation related to cataract surgery.
Age

Payable for patients 18 years of age and older.

Except as described in payment rule #2, OCT is an insured service only: a. for the diagnosis and management of retinal disease and/or glaucoma; and b. when the ophthalmologist performing the service is the physician most responsible for the care of the patient's retinal disease and/or glaucoma.

Any OCT service rendered in whole or in part for preparation related to cataract surgery is not eligible for payment.

G818, G820, G821 and G822 are not eligible for payment when rendered on a patient younger than 18 years of age.

G822 is only eligible for payment when the limit of any combination of G818, G820 or G821 is reached.

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