< Billing codes

Billing code

A241A

Neuro-ophthalmology, optometrist referral

A fellowship-trained neuro-ophthalmologist bills A241 for an optometrist-requested assessment of a neuro-ophthalmic disorder, documenting at least 4 of 7 exam elements.

Watch for: Limited to 1 per patient per physician per 24 months, and only for that fellowship training and disorder.

Code

A241A

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

Optometrist-requested assessment by a fellowship-trained neuro-ophthalmologist for a neuro-ophthalmic disorder. At least 4 of 7 exam elements.

What it covers

An assessment that includes all elements of an ORA (A253) for a patient with a neuro-ophthalmic disorder, on an optometrist's written request (A160).

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 (A160).

Billing rules

• Only payable to an ophthalmologist with fellowship training in neuro-ophthalmology (A160).
• Only for a patient with a neuro-ophthalmological disorder (A160).
• At least 4 of the 7 exam elements must be documented (A160).
• Limited to 1 per patient per physician per 24 months (A160).
• If the patient wasn't referred for neuro-ophthalmology or doesn't have such a disorder, use the general listings (A160).
• Detention (K001) may start after 60 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).

Common rejections

• AM1: Service limit exceeded: A241 is limited to 1 per patient per physician per 24 months (A160).

Related codes: A231, A253, A256, A931, C231

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Ophthalmology (23), page A160.

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