A384 – Medical Specific Re-Assessment
OHIP General Listings Code — Neurology (18) · Schedule of Benefits
A Consultation and Management for ACVS is a service in which the physician provides all the elements of a consultation (A185) to a patient referred for suspected ACVS and, if necessary, treatment with intravenous thrombolysis therapy and post-administration monitoring.
When to Use
- Bill A384 for a patient presenting to the emergency department with sudden onset neurological deficits suggestive of stroke, who meets the Canadian Stroke Best Practices timeframe for thrombolysis assessment.
- Use A384 when a patient is referred to neurology from the ED for suspected Acute Cerebral Vascular Syndrome (ACVS) and requires immediate assessment for potential intravenous thrombolysis, even if the patient is not formally admitted as an inpatient.
- A384 is appropriate for the initial assessment and management of a suspected stroke patient in an outpatient clinic setting if they are within the thrombolysis window and referred specifically for this purpose.
Common Pitfalls
- Failure to document the exact start and stop times of physician attendance, as well as the time of symptom onset, will lead to rejection of A384 claims.
- Billing A384 for a patient who does not meet the Canadian Stroke Best Practices timeframe for thrombolysis eligibility, or for whom thrombolysis is not being considered, is incorrect.
- Submitting A384 for a patient who is already an inpatient receiving stroke care; C384 is the appropriate code in that scenario.
Billing Tips
- Ensure all elements of a Neurology Consultation (A185) are included in the service provided when billing A384.
- If thrombolysis is administered and monitoring extends beyond the initial 30 minutes, bill the add-on code K181 for each subsequent 30-minute unit of constant attendance.
Effective: June 1, 2025
Consultations and Visits
Neurology (18)
Neurology
Consultation
The physician must remain in constant attendance with the patient.
The service must include all elements of a consultation (A185).
Start and stop times of the service must be recorded in the patient's permanent medical record.
The time of onset of symptoms must be recorded in the patient's permanent medical record.
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