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A034

A034Partial Assessment - General Surgery

OHIP General Listings Code — General Surgery (03) · Schedule of Benefits

A partial assessment is a limited service that constitutes a history of the presenting complaint, the necessary physical examination, advice to the patient, and an appropriate record of the encounter.

When to Use

  • Bill A034 for a follow-up visit after a minor surgical procedure where the patient's presenting complaint is being reviewed, but a full specific assessment (A033) is not warranted.
  • Use A034 when a general surgeon sees a patient in the Emergency Department or Outpatient Department (OPD) for a limited assessment of a new surgical complaint, and the patient is not admitted.
  • A034 is appropriate for a brief review of a patient's surgical condition that does not involve a detailed history and examination of a new, complex problem, differentiating it from a full consultation (A035).

Common Pitfalls

  • Billing A034 on the same day as a surgical procedure (unless it's a Z-prefix or IOP) will lead to rejection, as routine post-operative care is bundled into the surgical fee.
  • A034 is not eligible for the Chronic Disease Assessment Premium (E078) because General Surgery is not an eligible specialty for this premium.
  • Avoid billing A034 for hospital in-patients; use C034 (Specific Re-assessment) for these scenarios.

Billing Tips

  • For virtual care, append suffix 'A' to A034 (e.g., A034A) provided the service meets the criteria for comprehensive virtual care.
  • Unlike A033 (Specific Assessment), A034 does not have a stated frequency limit per 12-month period, allowing for more frequent partial assessments if clinically justified.
Provider Fee$0.00
Specialist Fee$28.60

Effective: June 1, 2025

Category

Consultations and Visits

Subcategory

General Surgery (03)

Service Type

Consultations and Visits

Code Classes

Assessment

History of the presenting complaint.

Necessary physical examination.

Advice to the patient.

Maintenance of an appropriate medical record.

Physicians in hospital but not on duty in the Emergency Department should use General Listings (A034) when seeing patients in the Emergency or OPD.

For hospital in-patients, the corresponding code is C034 (Specific re-assessment).

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