All codes
A033
A033 – Specific Assessment - General Surgery
OHIP General Listings Code — General Surgery (03) · Schedule of Benefits
A specialist service requiring 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 A033 for a new patient presenting with a specific surgical complaint, such as acute appendicitis, requiring a focused history and physical exam to confirm the diagnosis.
- Use A033 when a patient is referred for evaluation of a specific surgical issue, like a suspected hernia, and the assessment leads to a surgical plan but not immediate admission.
- Bill A033 for a follow-up assessment of a specific surgical problem that is distinct from a previous consultation (A035) or a repeat consultation (A036).
Common Pitfalls
- Billing A033 for a patient already admitted to hospital; use C033 instead for in-patients.
- Submitting A033 for a general assessment of multiple unrelated issues; this code is for a specific complaint.
- Billing A033 more than once per patient per 12 months without a documented, unrelated second diagnosis, which will result in payment adjustment to A034.
Billing Tips
- Ensure documentation clearly outlines the specific presenting complaint and the focused examination performed, differentiating it from a broader consultation (A035).
- If a patient requires a second specific assessment within 12 months for a new, unrelated surgical problem, clearly document the second diagnosis to justify the repeat A033 claim.
Provider Fee$0.00
Specialist Fee$47.30
Effective: June 1, 2025
Category
Consultations and Visits
Subcategory
General Surgery (03)
Service Type
Consultations and Visits
Code Classes
Assessment
Full history of the presenting complaint.
Detailed examination of the affected part(s), region(s), or system(s) needed to make a diagnosis, exclude disease, and/or assess function.
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