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A480 – Complex rheumatology assessment

OHIP Consultations and Visits Code — CONSULTATIONS AND VISITS · Schedule of Benefits

Levels of this visit

The A48x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

  • A488 Partial assessment

    A partial assessment is the limited service that constitutes a history of the presenting complaint, the necessary physical examination, advice to the patient and appropriate…

    $44.75
  • A484 Medical specific re-assessment

    A medical specific re-assessment is a service rendered by a specialist in rheumatology that requires a full, relevant history and physical examination of one or more systems.

    $72.00
  • A481 Complex medical specific re-assessment

    A complex medical specific re-assessment is a re-assessment of a patient because of the complexity, obscurity, or seriousness of the patient’s condition.

    $83.40
  • A483 Medical specific assessment

    A medical specific assessment is a service rendered by a specialist in Rheumatology in a place other than a patient's home.

    $95.95
  • A480 Complex rheumatology assessment(this code)

    A complex rheumatology assessment is an assessment for the ongoing management of specific complex disorders of the musculoskeletal system where the complexity of the condition…

    $113.85

Consultations

  • A486 Repeat consultation

    Repeat consultation rendered by a specialist in Rheumatology.

    $125.10
  • A485 Consultation

    A consultation is an assessment rendered following a written request from a referring physician, nurse practitioner or dental surgeon who requests the opinion of a rheumatologist…

    $202.40
A complex rheumatology assessment is an assessment for the ongoing management of specific complex disorders of the musculoskeletal system where the complexity of the condition requires continuing management by a rheumatologist. It is not intended for the evaluation and/or management of uncomplicated rheumatologic disorders such as osteoarthritis, bursitis/tendonitis, or neck and back pain.
Must include the elements of a medical specific re-assessment: a full, relevant history and physical examination of one or more systems.
Not for patients with uncomplicated disorders like osteoarthritis, bursitis, tendonitis, or neck/back pain.
Usage limits
Limited to 6 per patient, per physician, per 12 month period. Services in excess of this limit will be adjusted to a lesser assessment fee.

Examples of systemic vasculitides include Churg-Strauss angiitis, polyarteritis nodosa, Wegener’s granulomatosis, Takayasu’s vasculitis, microscopic polyangiitis, and temporal arteritis.

If the service does not meet the requirements of a medical specific re-assessment, it will be adjusted to a lesser fee.

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