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A570
A570 – Respiratory disease consultation
OHIP General Listings Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A consultation for respiratory disease, requiring a written request from a referring physician, nurse practitioner, or dental surgeon, and a written report of findings and recommendations.
When to Use
- Bill A570 for a new patient presenting with severe, undiagnosed shortness of breath requiring complex differential diagnosis and management planning, as evidenced by a referral letter detailing these concerns.
- Use A570 when a patient is referred for evaluation of suspected interstitial lung disease, necessitating a comprehensive review of imaging, pulmonary function tests, and a detailed written report outlining diagnostic and treatment strategies.
- Claim A570 for a patient referred for assessment of refractory asthma not responding to standard therapies, where a specialist opinion is required to investigate alternative causes or advanced treatment options.
Common Pitfalls
- Claiming A570 for routine follow-up of stable COPD or emphysema; these scenarios are better billed using general assessment codes like A007.
- Failure to obtain and retain a signed written request from the referring physician, nurse practitioner, or dental surgeon, which is a mandatory requirement for A570.
- Not providing a comprehensive written report of findings and recommendations to the referring provider, leading to potential fee reduction or audit adjustments.
Billing Tips
- Ensure the written report accompanying an A570 claim includes a detailed assessment and specific recommendations, going beyond a simple summary of findings.
- Verify that the patient's condition is not an 'uncomplicated respiratory disorder' as per the code's restrictions; if it is, use a general assessment code instead of A570.
Provider Fee$0.00
Specialist Fee$93.00
Effective: June 1, 2025
Category
A. Consultations and Visits
Subcategory
CONSULTATIONS AND VISITS
Service Type
Consultation
Code Classes
Consultation
If the consultation requirements (request/report) are not met, the fee will be reduced to a lesser assessment fee.
A570 is specifically listed under the Respiratory Disease section (Specialty 47).
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