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A448
A448 – Subsequent visits per month (nursing home or home for the aged)
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 appropriate record, rendered by a Medical Oncologist.
When to Use
- Bill A448 for a follow-up visit for a patient with a chronic condition, such as chemotherapy side effects, where a focused history, exam, and advice are provided in your office.
- Use A448 when a patient with a stable chronic disease requires a brief assessment and management plan update, distinct from a comprehensive new patient or specialist consultation (e.g., K005, K007).
- A448 is appropriate for a patient requiring a quick check-in for a chronic condition management in an outpatient setting, not in a nursing home or home for the aged (which would be W448).
Common Pitfalls
- Billing A448 for a patient seen in a nursing home or home for the aged; these settings require W448, which has a limit of 3 visits per month.
- Submitting A448 on the same day as another assessment code (e.g., A007, A008, K005) for the same patient by the same physician, as this is not permitted.
- Failing to include the required elements (history, exam, advice, record) when billing A448, which can lead to audits or claim rejections.
Billing Tips
- Consider adding the Chronic Disease Assessment Premium (E078) to A448 if the patient has a documented chronic disease and meets the eligibility criteria, ensuring the appropriate diagnostic code is submitted.
- When billing A448 for virtual care, remember to append the suffix 'A' to the code.
Provider Fee$0.00
Specialist Fee$38.05
Effective: June 1, 2025
Category
A. Consultations and Visits
Subcategory
CONSULTATIONS AND VISITS
Service Type
Partial Assessment
Code Classes
Assessment
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