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Billing code

G822A — Oct Unilateral Or Bilateral - Active Management With Laser Or Intravitreal Injections

OCT beyond the usual limit

Bill G822 for OCT during laser or injection treatment of wet AMD, diabetic macular edema or vein occlusion, after the G818/G820/G821 limit.

Watch for: Payable only once the combined limit of 4 is reached; maximum 8 per 12 months and 16 per 24 months.

Code

G822A

Description

Oct Unilateral Or Bilateral - Active Management With Laser Or Intravitreal Injections

FHO+ basket

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

Effective date

Apr 1, 2025

Termination date

No end date

Explanation

Updated October 26, 2026

OCT during laser or injection treatment of neovascular disease (wet AMD, diabetic macular edema, vein occlusion) once other OCT limits are used.

What it covers

OCT, unilateral or bilateral, during active management with laser or intravitreal injections for neovascularization associated with retinal disease (e.g. wet macular degeneration), diabetic macular edema, or retinal vein occlusion (J93).

The physician interprets the results and either performs or supervises the test; it may be unilateral or bilateral (J93).

Billing rules

• OCT is insured only for diagnosing and managing retinal disease and/or glaucoma, by the ophthalmologist most responsible for that care (J93).
• OCT done in whole or in part to prepare for cataract surgery is not payable (J93).
• The same physician must claim a consultation or assessment for the same condition; it doesn't have to be on the same day (J94).
• Only one of G818, G820, G821, G822 or G823 per patient per day (J94).
• Payable only once the combined limit for G818, G820 and G821 (4 per 12 months) has been reached (J93, J94).
• Limited to 8 per patient per 12 months and 16 per patient per 24 consecutive months (J93).
• Not payable for patients under 18 (J93).

Often billed with

• E186/E187 or E149 intravitreal injections (Y6).

Common rejections

• AM1: Service limit exceeded: G822 is limited to 8 per 12 months and 16 per 24 months, and needs the G818/G820/G821 limit reached first (J93).
• A2A: Outside of age limit: G822 is not payable for patients under 18 (J93).

Related codes: G821, G818, G820, G823, E186, E187

Source: Schedule of Benefits (July 1, 2026), Diagnostic and Therapeutic Procedures, Ophthalmology, page J93.

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