A614 – Medical Specific Re-Assessment
OHIP General Listings Code — Haematology (61) · Schedule of Benefits
A medical specific re-assessment is a service rendered by a specialist in Haematology (61) that requires a full, relevant history and physical examination of one or more systems.
When to Use
- Bill A614 for a Haematologist performing a comprehensive re-assessment of a patient's blood disorder in their office, including a detailed history and physical exam of relevant systems.
- Use A614 when a Haematologist sees a patient in the hospital's Out-Patient Department for a re-assessment of their haematological condition, provided the physician is not on duty in the Emergency Department.
- A Haematologist can bill A614 for a patient they previously assessed for the same illness before the patient was admitted to hospital, effectively treating the admission assessment as a re-assessment.
Common Pitfalls
- Billing A614 for a patient already admitted to hospital without having assessed them prior to admission for the same illness; this scenario may require C614 instead.
- Exceeding the limit of two A614 claims per patient per physician within a 12-month period, unless the exceptions for hospital admissions apply, as claims over the limit will be adjusted.
- Billing A614 for a partial assessment (A618) or a general assessment (A613) when the specific requirements of a full, relevant history and physical examination of one or more systems for a medical re-assessment are not met.
Billing Tips
- When A614 is rendered in conjunction with a special visit premium in the Emergency or Out-Patient Department, ensure you use the A-prefix assessment fee (A614).
- Consider billing the chronic disease assessment premium (E078) with A614 for eligible patients with an established chronic disease seen in the office or hospital out-patient clinic, but not in the ED or as inpatients.
Effective: June 1, 2025
Consultations and Visits
Haematology (61)
Consultations and Visits
Assessment
Requires a full, relevant history and physical examination of one or more systems.
Admission assessments are deemed to be a medical specific re-assessment if the physician assessed the patient prior to admission for the same illness.
If the physician is in the hospital but not on duty in the Emergency Department when seeing patients in the Emergency or OPD, use General Listings (A614).
For services not listed in the Haematology section, refer to the Internal Medicine Section.
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