A210 – Special anaesthetic consultation
OHIP General Listings Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A special anaesthetic consultation is a consultation rendered by an anaesthesia (01) specialist that includes all appropriate elements of a regular consultation and requires a minimum of 50 minutes of direct contact with the patient, exclusive of time spent on other separately billable interventions or non-patient-facing activities.
When to Use
- Bill A210 for a complex pre-operative assessment of a patient with multiple comorbidities (e.g., severe COPD, uncontrolled diabetes, ischemic heart disease) requiring a thorough review and discussion of anesthetic risks, exceeding the scope of a routine pre-anesthetic assessment.
- Utilize A210 when a patient requires a detailed anesthetic consultation for a non-elective, high-risk surgical procedure where significant anesthetic planning and risk stratification are necessary, beyond what is covered by A015.
- Consider A210 for patients with a history of difficult airway management or adverse anesthetic reactions, necessitating an in-depth consultation to plan for safe anesthetic delivery.
Common Pitfalls
- Billing A210 for a routine pre-anesthetic evaluation for low-risk elective procedures (e.g., cataract surgery) without documented medical necessity, as this is typically included in the surgical fee or covered by P014C.
- Failing to document the minimum 50 minutes of direct patient contact, leading to potential fee adjustment or rejection.
- Submitting A210 when the patient's condition or the procedure does not warrant a 'special' consultation, potentially leading to claims being downgraded to A015 or A016.
Billing Tips
- Ensure the referral clearly states the reason for a 'special' anesthetic consultation, differentiating it from a routine pre-anesthetic assessment.
- Clearly document the start and end times of the patient encounter in the medical record to substantiate the 50-minute requirement for A210.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Consultation
Consultation
Minimum of 50 minutes of direct patient contact ().
Start and stop times must be recorded in the patient's permanent medical record ().
Must include a written report with findings, opinions, and recommendations sent to the referring provider ().
The consultant must perform a general, specific, or medical specific assessment, including a review of all relevant data ().
Non-patient-facing time (e.g., chart review, imaging, documentation) is excluded from the 50-minute requirement.
Preoperative consultations for low-risk elective procedures (cataract surgery, colonoscopy, cystoscopy, carpal tunnel surgery, or arthroscopic surgery) are only eligible if medically necessary and documented.
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