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A618
A618 – Partial Assessment
OHIP General Listings Code — Haematology (61) · Schedule of Benefits
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 record.
When to Use
- Bill A618 for a focused history, examination, and advice on a new, specific complaint, such as a patient presenting with a new rash or a sudden onset of joint pain, where a full assessment (A007) is not warranted.
- Use A618 when a patient requires a brief assessment of a single, well-defined problem, distinct from a follow-up visit (A003) or a more comprehensive assessment (A007).
- A618 is appropriate for a specialist performing a limited assessment of a specific issue within their specialty, for example, a hematologist evaluating a new abnormal blood count result.
Common Pitfalls
- Billing A618 when a more comprehensive assessment code like A007 is indicated by the complexity and scope of the patient's condition and the services provided.
- Submitting A618 for a routine follow-up of a previously assessed condition; A003 or A004 would be more appropriate in such cases.
- Claiming A618 for a service that is essentially a consultation without a focused history, examination, and advice specific to the presenting complaint.
Billing Tips
- Ensure the documentation clearly outlines the specific presenting complaint, the targeted examination performed, and the advice given, differentiating it from a general assessment.
- A618 is not payable on the same day as other assessment codes (e.g., A007, A613) by the same physician for the same patient, unless specific exceptions apply.
Provider Fee$0.00
Specialist Fee$38.05
Effective: June 1, 2025
Category
Consultations and Visits
Subcategory
Haematology (61)
Service Type
Consultations and Visits
Code Classes
Assessment
History of presenting complaint
Necessary physical examination
Advice to the patient
Appropriate record
Haematology (61) is an eligible specialty for the E078 premium.
Special visit premiums (Travel and First Person Seen) may be applicable if the visit is non-elective and initiated by the patient.
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