A173 – Specific assessment - Vascular Surgery
OHIP General Listings Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A specific assessment is a service rendered by a specialist in a place other than a patient’s home, requiring a full history of the presenting complaint and a detailed examination of the affected part(s), region(s), or system(s) needed to make a diagnosis, and/or exclude disease, and/or assess function.
When to Use
- Bill A173 when a vascular surgeon performs a comprehensive history and detailed physical exam for a new patient presenting with claudication, requiring a diagnosis and management plan.
- Use A173 for a patient referred for evaluation of a suspected abdominal aortic aneurysm (AAA) requiring a full vascular assessment, even if no immediate intervention is planned.
- A173 is appropriate for a patient with a non-healing lower extremity ulcer requiring a detailed vascular assessment to determine the cause and treatment strategy.
Common Pitfalls
- Billing A173 for a follow-up visit after an initial assessment; use A174 (Partial assessment) for subsequent non-specific visits.
- Submitting A173 more than once per patient per 12 months without a clearly unrelated, new diagnosis, which will result in adjustment to A174.
- Using A173 when the patient is admitted to hospital; C173 (Specific assessment - In-patient) is the correct code for inpatient admissions.
Billing Tips
- If A173 leads to hospital admission, it covers the admission assessment, and subsequent inpatient visits should be billed using appropriate codes like C122 or C123.
- A173 can be billed with the 'A' suffix for virtual care, provided the documentation requirements for history and examination are met virtually.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Consultations and Visits
Assessment
Full history of the presenting complaint.
Detailed examination of the affected part(s), region(s), or system(s).
Service must be rendered in a place other than the patient's home (e.g., office or hospital out-patient department).
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.