A270 – Complex infectious disease assessment
OHIP General Listings Code · Schedule of Benefits
This service is an assessment for the ongoing management of any of the following infectious diseases where the complexity of the condition requires the continuing management by an infectious disease specialist 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:
When to Use
- Bill A270 for a patient requiring IV vancomycin for MRSA osteomyelitis managed at home, provided the 20-minute direct contact requirement is met.
- Use A270 when managing a patient with an ESBL-producing E. coli UTI requiring IV ceftazidime-azobactam therapy outside of a hospital setting.
- A270 is appropriate for the ongoing management of a patient with disseminated histoplasmosis requiring long-term azole therapy, when the complexity warrants specialist oversight.
Common Pitfalls
- Billing A270 for patients with latent TB infection; this code is only for active tuberculosis disease.
- Failing to document the start and stop times of the patient encounter in the medical record, leading to payment adjustment to a lesser assessment fee.
- Including time spent on other separately billable procedures, such as minor surgical excisions, when calculating the 20-minute minimum for A270.
Billing Tips
- Ensure the patient's condition meets one of the specified complex infectious disease criteria (e.g., MDR organism requiring IV therapy, deep fungal infection) to justify A270 over a general assessment code like A463.
- A270 can be billed in conjunction with E078 (Chronic disease assessment premium) if the patient has a documented chronic disease and the visit occurs in an office or hospital outpatient setting.
Effective: April 1, 2026
Infectious Disease (46)
Assessment
Minimum of 20 minutes in direct contact with the patient, exclusive of time spent rendering any other separately billable intervention to the patient.
Must include all elements of a 'specific assessment' (as defined in ).
The start and stop times must be recorded in the patient’s permanent medical record or the amount payable for the service will be adjusted to a lesser paying fee.
If the service does not meet the 20-minute minimum or the specific clinical criteria, it will be adjusted to a lesser assessment fee.
Time spent on other separately billable procedures cannot be counted toward the 20-minute minimum.
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