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A044

A044Partial Assessment

OHIP General Listings Code — Neurosurgery (04) · 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

  • Use A044 for a focused history and physical examination of a new neurological complaint, distinct from a full consultation (A045) or a specific assessment (A043).
  • Bill A044 when a patient presents with a specific, limited neurological issue requiring a brief examination and advice, rather than a comprehensive workup.
  • A044 is appropriate for follow-up neurosurgical visits where a new, distinct issue arises that requires a focused assessment, but not a full re-evaluation.

Common Pitfalls

  • Billing A044 when a more comprehensive service like A045 (Consultation) or A043 (Specific Assessment) was performed, leading to potential claim rejection or audit.
  • Submitting A044 for a routine follow-up neurosurgical visit that does not involve a new presenting complaint or a focused examination, as this may not meet the criteria for a partial assessment.
  • Failing to document the specific presenting complaint, examination findings, and advice provided, which are required elements for A044 and can lead to claim disputes.

Billing Tips

  • Remember that A044 is the neurosurgery-specific code for a partial assessment, analogous to A007 for other specialties.
  • A044 can be billed with special visit premiums (e.g., K990, C990, A990) if the conditions for non-elective hospital, long-term care, or home visits are met and documented.
Provider Fee$0.00
Specialist Fee$30.00

Effective: June 1, 2025

Category

Consultations and Visits

Subcategory

Neurosurgery (04)

Service Type

Consultations and Visits

Code Classes

Assessment

A044 is specifically listed under the Neurosurgery (04) General Listings.

Not eligible for the Chronic Disease Assessment Premium (E078) as Neurosurgery is not an eligible specialty for that premium.

Not eligible for Age-Based Fee Premiums () as it is not listed among the eligible assessment codes.

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