All codes
A084
A084 – Partial assessment
OHIP General Listings Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A partial assessment is the limited service that constitutes a history of the presenting complaint, the necessary physical examination, advice to the patient and appropriate record.
When to Use
- Bill A084 for a patient presenting to the Emergency Department or Outpatient Department (OPD) with a new complaint, when you are not on duty for that specific department.
- Use A084 when a patient requires a brief assessment of a new, non-urgent issue that does not warrant a full consultation (A085) or specific assessment (A083).
- A084 is appropriate for a patient who presents with a single, self-limiting complaint requiring history, examination, and advice, with no expectation of ongoing follow-up within the same encounter.
Common Pitfalls
- Billing A084 for routine follow-up of a chronic condition or for a patient already admitted as an inpatient; these scenarios require different codes.
- Claiming A084 when the service provided was a simple procedure or injection that is separately billable, as the advice component is considered inclusive.
- Using A084 for elective admissions or routine hospital rounds, as this code is intended for non-elective, patient-initiated visits.
Billing Tips
- A084 is eligible for virtual care (video or telephone) provided all physical service requirements (history, exam, advice, record) are met and the visit is non-elective and patient-initiated.
- This code can be billed with Special Visit Premiums (e.g., K960, K990) and the Chronic Disease Assessment Premium (if criteria are met) in applicable settings.
Provider Fee$0.00
Specialist Fee$29.90
Effective: June 1, 2025
Category
A. Consultations and Visits
Subcategory
CONSULTATIONS AND VISITS
Service Type
Consultations and Visits
Code Classes
Assessment
If seeing a patient in the Emergency or OPD while not on duty, use this General Listing code.
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