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A318

A318Partial Assessment

OHIP General Listings Code — Physical Medicine & Rehabilitation (31) · 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.

When to Use

  • Bill A318 when a patient presents with a single, well-defined complaint requiring a focused history, limited physical exam, and brief advice, such as a follow-up for a minor musculoskeletal strain.
  • Use A318 for a patient requiring a brief assessment of a new, non-urgent symptom, like a localized rash, where a full A313 or A310 is not warranted.
  • A318 is appropriate for a patient needing a quick check of a specific issue, like assessing a recent minor injury that doesn't require a comprehensive consultation (A315).

Common Pitfalls

  • Billing A318 when the service provided meets the criteria for a more complex assessment like A510 or A511, leading to underbilling.
  • Claiming A318 on the same day as another assessment or consultation (e.g., A313, A315) by the same physician for the same patient, unless specific exceptions apply.
  • Failing to document the specific presenting complaint, examination findings, and advice given, which are required for A318 and can lead to audit issues.

Billing Tips

  • A318 can be billed with the E078 chronic disease assessment premium if the patient has a documented chronic condition and the assessment is performed in an office or hospital outpatient setting.
  • Ensure the documentation clearly distinguishes the service from a general re-assessment (A310) by focusing on the presenting complaint and limited scope.
Provider Fee$0.00
Specialist Fee$39.70

Effective: June 1, 2025

Category

Consultations and Visits

Subcategory

Physical Medicine & Rehabilitation (31)

Service Type

Consultations and Visits

Code Classes

Assessment

A318 is considered a 'lesser assessment fee' in the context of Physical Medicine & Rehabilitation. If the requirements for more complex assessments (like A510 or A511) are not met, the service may be adjusted to a lesser assessment fee such as A318.

The fee for A318 is $44.45.

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