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A013
A013 – Specific Assessment - Anaesthesia
OHIP General Listings Code — Anaesthesia (01) · Schedule of Benefits
A specialist assessment rendered by an anaesthesiologist (specialty 01) in a place other than the patient's home. It requires a full history of the presenting complaint and a detailed examination of the affected part(s), region(s), or system(s) needed to make a diagnosis, exclude disease, and/or assess function.
When to Use
- Bill A013 for an anaesthesiologist's assessment of a patient with a complex chronic pain condition requiring specialist input, separate from any planned surgical procedure.
- Use A013 when an anaesthesiologist provides a pre-operative assessment for a patient undergoing a procedure where the anaesthetic plan is particularly complex or high-risk, and this assessment is not part of the routine pre-anaesthetic evaluation for that specific procedure.
- A013 is appropriate for an anaesthesiologist's assessment of a patient referred by another physician for evaluation of a specific respiratory or cardiac issue impacting anaesthetic management, where no immediate procedure is planned.
Common Pitfalls
- Avoid billing A013 if the assessment is for a routine pre-anaesthetic evaluation for a planned procedure; this is considered part of the procedural fee and not separately billable.
- Do not bill A013 for hospital in-patients; use C013 instead for in-patient specific assessments.
- Submitting A013 more than once per patient per 12 months without meeting the criteria for a second assessment (different diagnosis or 90+ days post-first assessment for hospital admission) will lead to rejection.
Billing Tips
- Ensure the patient's chart clearly documents a full history and detailed examination specifically related to the presenting complaint, justifying the need for a specialist anaesthesia assessment beyond routine perioperative care.
- If the A013 assessment is for a new, distinct diagnosis within 12 months of a previous A013, clearly document the new diagnosis in the patient's record to support the second claim.
Provider Fee$0.00
Specialist Fee$64.65
Effective: June 1, 2025
Category
Consultations and Visits
Subcategory
Anaesthesia (01)
Service Type
Consultations and Visits
Code Classes
Assessment
The routine pre-anaesthetic evaluation does not constitute a consultation or assessment regardless of where or when it is performed.
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