All codes
A134
A134 – Medical specific re-assessment
OHIP General Listings Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A service rendered by a specialist in Internal Medicine requiring a full, relevant history and physical examination of one or more systems.
When to Use
- Use A134 for a follow-up re-assessment of a patient with a stable chronic condition managed by Internal Medicine, where a focused history and physical exam are performed.
- Bill A134 when a specialist in Internal Medicine sees a patient for a new issue related to a previously managed condition, requiring a new history and physical exam of relevant systems.
- A134 is appropriate for a specialist follow-up visit where the patient's condition has changed significantly, necessitating a comprehensive review of history and a targeted physical examination.
Common Pitfalls
- Billing A134 more than twice per patient per 12 months without meeting the hospital admission exception will lead to claims being adjusted to A138 (Partial assessment).
- Submitting A134 on the same day as another assessment code (e.g., A133, A131) or psychotherapy/counseling codes by the same physician will result in rejection.
- Claiming A134 for a patient whose condition is complex or obscure may be inappropriate; consider A131 (Complex medical specific re-assessment) and its associated report requirement instead.
Billing Tips
- When admitting a patient, if you were the MRP for the same illness prior to admission, consider using C134 (In-patient) and applying the E082 premium for an admission assessment.
- If A134 is billed for a patient seen within 24 hours of trauma and the patient has a qualifying ISS score, the E420 trauma premium can be added.
Provider Fee$0.00
Specialist Fee$61.25
Effective: June 1, 2025
Category
A. Consultations and Visits
Subcategory
CONSULTATIONS AND VISITS
Service Type
Consultations and Visits
Code Classes
Assessment
Admission assessments are deemed to be a medical specific re-assessment (C134) if the physician has assessed the patient prior to admission for the same illness.
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