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Billing code

C233A — Ophthalmology specific assessment – hospital in-patient

Ophthalmology in-patient specific assessment

Bill when an ophthalmologist takes a full history of the complaint and does a detailed exam for a non-emergency hospital in-patient.

Watch for: One per patient per physician per 12 months, two only for a clearly unrelated diagnosis; tonometry (G435) is included.

Code

C233A

Description

Ophthalmology specific assessment – hospital in-patient

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

Specific assessment by an ophthalmologist for a non-emergency hospital in-patient: full history of the complaint and detailed eye exam.

What it covers

The in-patient specific assessment for ophthalmology (A162). A specific assessment needs a full history of the presenting complaint and a detailed exam of the affected parts or systems needed to make a diagnosis, exclude disease or assess function (GP23).

Ophthalmology visits may include retinal photography as part of the service where medically necessary (A154).

Billing rules

• Limited to 1 per patient per physician per 12 months, or 2 if the patient returns with a clearly different, unrelated diagnosis. Extras pay at a lesser assessment fee (GP23).
• In-patient rules apply (GP40–GP48). For emergency calls and other special visits to in-patients, use the general listings (A-prefix) and special visit premiums instead (A162).
• Tonometry G435 is included and not billed separately (J89).
• Video only. For an in-patient, virtual care is payable only if you aren't the MRP, no local physician with the expertise is available (documented by the referrer), and the referrer assessed the patient in person within 30 days (AJ2, A69).

Often billed with

• Ophthalmology diagnostic tests billed separately, such as OCT or fluorescein angiography (J3, J90, J93).

Common rejections

• AT2: Must include video modality: C233 is video-only by virtual care (AJ2).

Related codes: A233, C234, C235, C232, C238

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Ophthalmology (23), page A162.

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