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G822
G822 – OCT unilateral or bilateral - active management with laser or intravitreal injections for neovascularization
OHIP Diagnostic & Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
OCT unilateral or bilateral - active management with laser or intravitreal injections for neovascularization associated with: - i. retinal disease, e.g. wet acute macular degeneration; - ii. diabetic macular edema; or - iii. retinal vein occlusion when the physician interprets the results and either performs the procedure or supervises the performance of the procedure.
When to Use
- Use G822 when performing an OCT to guide the decision-making process for an intravitreal anti-VEGF injection for wet AMD, DME, or RVO.
- Use this code when monitoring the response to laser photocoagulation for neovascularization in patients with diabetic retinopathy or retinal vein occlusion.
Common Pitfalls
- Billing G822 for routine diagnostic screening or monitoring of stable conditions that do not currently require active laser or injection therapy will lead to rejection.
- Submitting G822 for OCT scans performed for pre-operative assessment or post-operative planning for cataract surgery is strictly prohibited and will trigger an audit.
- Attempting to bill G822 alongside G818, G820, G821, or G823 on the same day will result in the rejection of the second claim due to the daily limit restriction.
Billing Tips
- Ensure the clinical note explicitly links the OCT findings to the specific decision to proceed with or modify the current laser or injection treatment plan to satisfy the 'active management' requirement.
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