< Billing codes

Billing code

A931A

Optometrist-referred uveitis assessment

Bill A931 when an optometrist asks a fellowship-trained uveitis ophthalmologist to assess uveitis or ocular or orbital inflammatory disease.

Watch for: Limited to 1 per patient per physician per 24 months; document the dilated fundus exam and study analysis.

Code

A931A

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 uveitis ophthalmologist for uveitis or ocular or orbital inflammatory disease.

What it covers

An assessment that includes all elements of an ORA (A253) for a patient with a uveitis, ocular inflammatory or orbital inflammatory disorder, on an optometrist's written request (A159).

A dilated fundus exam and analysis of the lab, radiological and ocular imaging studies done to investigate the inflammatory disease must be documented (A159–A160).

Billing rules

• Only payable to an ophthalmologist with fellowship training in uveitis and ocular inflammatory diseases (A159).
• Only for a patient with a uveitis, ocular inflammatory or orbital inflammatory disorder (A159).
• Document the dilated fundus exam and the analysis of lab and imaging studies (A159–A160).
• Limited to 1 per patient per physician per 24 months (A160).
• If the patient wasn't referred for this 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).

Common rejections

• AM1: Service limit exceeded: A931 is limited to 1 per patient per physician per 24 months (A160).

Related codes: A930, A253, A256, A241, C930

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Ophthalmology (23), page A159. Rules continue on A160.

APEX checks every paid claim against the Schedule of Benefits and flags codes billed below what the visit qualified for. See how APEX works · Pricing