A283 – Medical specific assessment
OHIP General Listings Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A service rendered by a specialist in Laboratory Medicine 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, exclude disease, and/or assess function.
When to Use
- Bill A283 when a specialist in Laboratory Medicine performs a detailed history and physical examination to diagnose a complex condition, differentiating it from a partial assessment (A284).
- Use A283 for a specialist's in-depth assessment of a specific organ system or disease process that requires more than a limited consultation (A286) but is not a broad consultation (A285).
- A283 is appropriate when a specialist in Laboratory Medicine needs to establish a baseline functional assessment for a patient with a newly diagnosed, complex condition.
Common Pitfalls
- Billing A283 for a service that could be adequately covered by a partial assessment (A284) or a limited consultation (A286) will likely result in rejection.
- Failure to document a detailed history and physical examination specific to the presenting complaint, as required for A283, is a common audit risk.
- Submitting A283 for an in-patient assessment; use C283 instead for hospital-based services.
Billing Tips
- Consider adding the E078 premium if the A283 assessment is for a patient with an established chronic disease from the approved list and is performed in an office or out-patient clinic.
- If A283 is the admission assessment and you are the MRP, the E082 premium can be added, but only once per hospital admission.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Clinical Assessment
Assessment
Full history of the presenting complaint.
Detailed examination of the affected part(s), region(s), or system(s) needed to make a diagnosis, exclude disease, and/or assess function.
Direct physical encounter with the patient (unless rendered via virtual care suffix A).
A283 is the 'General Listing' (typically office/out-patient) version of the medical specific assessment for Laboratory Medicine.
For in-patient services, see code C283.
Special visit premiums (-) may apply if the physician is called to see the patient on an urgent basis outside of regular office hours.
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