A027 – Consultation in Association with Special Visit to a Hospital in-Patient, Long-Term Care in-Patient or Emergency Department Patient
OHIP General Listings Code — Dermatology (02) · Schedule of Benefits
Consultation in association with special visit to a hospital in-patient, long-term care in-patient or emergency department patient.
When to Use
- Bill A027 when you are called to the Emergency Department for an urgent dermatology consult on a patient who is not being admitted.
- Use A027 when providing a consultation for a hospitalized patient requiring an immediate dermatology opinion outside of regular rounds.
- A027 is appropriate for a dermatology consultation requested by an NP for a patient in a long-term care facility with a new, complex skin issue.
Common Pitfalls
- Billing A027 for routine hospital rounds; this code requires a 'special visit' premium and is not for scheduled inpatient care.
- Submitting A027 without a written request from the referring physician, NP, or dental surgeon; this is a mandatory documentation requirement.
- Claiming A027 for a patient admitted electively to the hospital on the same day, as this is explicitly restricted.
Billing Tips
- Always append the appropriate special visit premium (C, W, or K prefix) to A027 to reflect the nature of the visit.
- Ensure the written report to the referring provider details findings, opinions, and specific recommendations, justifying the specialist consultation.
Effective: June 1, 2025
Consultations and Visits
Dermatology (02)
Specialist Consultation
Consultation
Written request from a referring physician, nurse practitioner, or dental surgeon
Written report to the referring provider including findings, opinions, and recommendations
Complexity, seriousness, or obscurity of the case requires a specialist's opinion
Visit must be non-elective and initiated by the patient or on their behalf
A copy of the written request for the consultation, signed by the referring physician, nurse practitioner or dental surgeon must be kept in the consulting physician’s medical record (or common medical record in hospital/LTC/multi-specialty clinic).
The request identifies the consultant by name and/or specialty, referring physician/NP/DS by name and billing number, and patient by name and health number.
The written request sets out the information relevant to the referral and specifies the service(s) required.
A027 is the specific consultation code used when a special visit premium is also being claimed in a hospital or LTC setting.
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