A183 – Complex neurological assessment
OHIP General Listings Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A complex neurological assessment is an assessment for the ongoing management of the following complex chronic neurological conditions where the complexity of the condition requires the continuing management by a neurologist and where the visit requires a minimum of 20 minutes in direct contact with the patient, exclusive of time spent rendering any other separately billable intervention to the patient: 1. the following diseases of the neuromuscular system a. generalized peripheral neuropathies; b. myopathies; c. diseases of the neuromuscular junction; or d. diseases of the motor neurone. 2. the following chronic central nervous system disorders: a. Malignant neoplasms (brain) b. Psychosomatic disturbances (functional neurological disorder) c. Chronic migraine or trigeminal autonomic cephalalgias d. Huntington’s chorea e. Trigeminal neuralgia f. Intracranial hemorrhage g. Stroke
When to Use
- Bill A183 for a neurologist managing a patient with generalized peripheral neuropathy requiring a detailed neurological exam and discussion of management options, lasting at least 20 minutes.
- Use A183 for a follow-up visit for a patient with a newly diagnosed brain tumor (malignant neoplasm) where the neurologist spends over 20 minutes assessing neurological deficits and discussing prognosis.
- A183 is appropriate for a neurologist managing a patient with Huntington's chorea, where the visit focuses on motor symptoms, cognitive changes, and psychosocial support, exceeding 20 minutes.
Common Pitfalls
- Billing A183 when the patient's condition does not meet the specific criteria listed (e.g., managing uncomplicated chronic migraine without neurological complexity).
- Failing to document the minimum 20 minutes of direct patient contact, exclusive of other procedures, leading to potential audits or claim rejections.
- Billing A183 for a condition that is not one of the specified chronic neurological disorders, even if the patient is seeing a neurologist.
Billing Tips
- A183 can be combined with the E078 Chronic Disease Assessment Premium if the patient has an established diagnosis from the specified list and the visit occurs in an office or hospital outpatient clinic.
- Ensure the documentation clearly distinguishes the time spent on the neurological assessment from any other separately billable procedures performed during the same visit.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Assessment
Assessments
All insured services must be documented in appropriate records that establish the service was provided, is the service submitted for, and was medically necessary.
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