All codes
A284
A284 – Partial assessment
OHIP General Listings Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A partial assessment is a limited service that constitutes a history of the presenting complaint, the necessary physical examination, advice to the patient, and an appropriate record. This code is specifically listed under the Laboratory Medicine specialty section.
When to Use
- Bill A284 when a Pathology specialist performs a focused history and physical examination for a specific laboratory-related complaint, such as reviewing abnormal test results with a patient.
- Use A284 for a limited assessment of a patient's condition that requires a physical exam and advice, but does not meet the criteria for a general assessment (A007) or specific assessment (A283).
- A284 is appropriate when a laboratory medicine physician provides a brief consultation involving a physical exam and management plan for a patient referred for a specific diagnostic question.
Common Pitfalls
- Billing A284 when a more comprehensive assessment code (e.g., A007, A283) is warranted by the complexity of the history, examination, or management plan.
- Submitting A284 for services that are primarily consultative without a direct physical examination component, unless billed as virtual care (A284A).
- Failure to document the specific components of a partial assessment (history, exam, advice, record) can lead to audit issues.
Billing Tips
- A284 is eligible for the E078 Chronic disease assessment premium if the service is rendered by a Pathology specialist (specialty 28) in an office or out-patient clinic setting for a patient with a documented chronic disease.
- Remember that A284 is considered a lesser assessment fee; if you bill a higher-level assessment on the same day to the same patient, OHIP may adjust the payment.
Provider Fee$0.00
Specialist Fee$38.85
Effective: June 1, 2025
Category
A. Consultations and Visits
Subcategory
CONSULTATIONS AND VISITS
Service Type
Partial assessment
Code Classes
Assessment
History of the presenting complaint.
Necessary physical examination.
Advice to the patient.
Appropriate medical record.
Must include a direct physical encounter with the patient (unless billed as virtual care A284A).
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