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Billing code

A231A — Neuro-ophthalmology consultation

Neuro-ophthalmology consultation

A fellowship-trained neuro-ophthalmologist bills A231 for a referred patient with a neuro-ophthalmological disorder, documenting at least 4 of 7 exam elements.

Watch for: Only for that fellowship training and disorder, with the referrer's billing number on the claim; otherwise use A235.

Code

A231A

Description

Neuro-ophthalmology consultation

FHO+ basket

Not in the FHO+ base rate basket (Schedule 2 or 2B).

Effective date

Apr 1, 2026

Termination date

No end date

Explanation

Updated October 26, 2026

Consultation by a fellowship-trained neuro-ophthalmologist for a patient with a neuro-ophthalmological disorder. At least 4 of 7 exam elements documented.

What it covers

A neuro-ophthalmology consultation for a referred patient with a neuro-ophthalmological disorder. At least four of these must be documented: detailed pupillary exam, detailed extraocular motility exam, ocular alignment testing, partial or complete neurological exam, detailed fundus exam, analysis of formal visual fields, and analysis of pertinent diagnostic imaging (A154).

If the patient was not referred for neuro-ophthalmology, or doesn't have a neuro-ophthalmological disorder, use the general listings such as A235 (A154).

Billing rules

• Only payable to an ophthalmologist with fellowship training in neuro-ophthalmology (A154).
• Only for a patient with a neuro-ophthalmological disorder (A154).
• At least 4 of the 7 listed exam elements must be documented (A154).
• General consultation rules apply: written referral, and limits of 1 per 2 consecutive 12-month periods for the same diagnosis (GP16–GP18).
• Age premiums for patients under 16 apply to specialist consultations (GP64).
• Detention (K001) may start after 90 minutes (GP30).
• Not listed in Appendix J, so not payable as a virtual service (AJ1–AJ2).

Often billed with

• Formal visual fields G858/G432 or G857/G436 (J91).
• OCT G818 or G820 when criteria are met (J93).

Common rejections

• ARF: The claim is missing the referring provider's number. A consultation needs a written request that names the referring physician or nurse practitioner and their billing number (GP16).

Related codes: A235, A241, C231, W231, A930, A236

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Ophthalmology (23), page A154.

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