All codes
A078
A078 – Partial assessment
OHIP General Listings Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A partial assessment is a limited medical service that includes a history of the presenting complaint, the necessary physical examination, advice to the patient, and an appropriate medical record.
When to Use
- Bill A078 for a 70-year-old patient presenting with a new complaint of memory loss, requiring a focused history, physical exam, and initial advice regarding potential causes.
- Use A078 when assessing a patient of any age specifically for a new or ongoing dementia concern, even if other minor complaints are also addressed.
- A078 is appropriate for a brief follow-up visit for a geriatric patient to review test results related to a previously identified, non-complex issue, where a full reassessment (A073/A074) is not warranted.
Common Pitfalls
- Billing A078 for a patient under 65 without a documented assessment specifically for dementia, leading to claim rejection.
- Submitting A078 on the same day as another assessment code (e.g., A073) or consultation by the same physician for the same patient, violating same-day restrictions.
- Failing to document the history of the presenting complaint, necessary examination, advice, and medical record, which are requirements for A078 and can lead to audit issues.
Billing Tips
- Ensure the medical record clearly indicates the assessment is for dementia if the patient is under 65, to justify the use of A078.
- Consider adding the E078 Chronic Disease Assessment Premium when billing A078 if the patient has an established chronic disease documented and the visit meets E078 criteria.
Provider Fee$0.00
Specialist Fee$45.30
Effective: June 1, 2025
Category
A. Consultations and Visits
Subcategory
CONSULTATIONS AND VISITS
Service Type
Office or Out-patient Clinic
Code Classes
Assessment
A078 is the Geriatrics-specific partial assessment code.
If the assessment is for dementia, it is eligible for payment regardless of the patient's age.
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