All codes
A158
A158 – 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 A158 for a brief follow-up of a stable chronic condition where only a focused history, minimal exam, and advice are provided, differentiating it from a more extensive A155 Consultation.
- Use A158 when a patient presents with a new, minor complaint requiring a quick assessment, examination, and advice, but not warranting a full A155 Consultation or a specialized assessment like A153.
- A158 is appropriate for a quick review of a single, uncomplicated symptom or sign, distinct from the broader scope of a comprehensive consultation (A155).
Common Pitfalls
- Billing A158 for a service that meets the criteria for a more complex assessment code (e.g., A155, A153) will likely result in a claim adjustment or rejection.
- Submitting A158 on the same day as another assessment or consultation code (e.g., A155, A150) by the same physician for the same patient will lead to non-payment for one of the services.
- Failure to document the history of the presenting complaint, necessary examination, advice, and appropriate record can lead to audit issues if A158 is chosen.
Billing Tips
- Ensure A158 is billed only when the service is truly limited in scope, reflecting a brief encounter focused on a specific complaint, examination, and advice.
- Remember that A158 counts towards the minimum of four assessments/consultations required in a 12-month period for a physician to be eligible for the K045 annual fee.
Provider Fee$0.00
Specialist Fee$39.10
Effective: June 1, 2025
Category
A. Consultations and Visits
Subcategory
CONSULTATIONS AND VISITS
Service Type
Consultations and Visits
Code Classes
Assessment
History of the presenting complaint.
Necessary physical examination.
Advice to the patient.
Appropriate medical record.
A155ConsultationA150Comprehensive endocrinology consultationA255Limited consultationA156Repeat consultationA153Medical specific assessmentA154Medical specific re-assessmentA151Complex medical specific re-assessmentA760Complex endocrine neoplastic disease assessmentK045Diabetes management by a specialist
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