A631 – Minor Assessment
OHIP General Listings Code — Nuclear Medicine (63) · Schedule of Benefits
A minor assessment is the service rendered when a nuclear medicine specialist evaluates a patient on a non-emergent basis resulting in the cancellation or deferral of a planned diagnostic nuclear medicine procedure due to procedural difficulties, including lack of patient cooperation, if no other diagnostic nuclear medicine procedure is rendered.
When to Use
- A patient refuses to remain still for a planned SPECT/CT scan, leading to its cancellation and a subsequent assessment by the nuclear medicine specialist.
- A planned bone scan is deferred because the patient is unable to follow instructions for breath-holding, requiring the specialist to assess the situation.
- A planned cardiac nuclear medicine study is cancelled due to patient anxiety and inability to cooperate, with the specialist performing a minor assessment.
Common Pitfalls
- Billing A631 when a diagnostic nuclear medicine procedure (e.g., I110, I120, I130) is performed on the same day, as this code is explicitly not payable in such circumstances.
- Using A631 when the cancellation or deferral is due to equipment malfunction or scheduling issues rather than patient-related procedural difficulties.
- Billing A631 for a routine follow-up assessment after a successful nuclear medicine procedure, as it's intended for pre-procedure cancellations/deferrals.
Billing Tips
- Ensure documentation clearly states the reason for cancellation/deferral was patient-related procedural difficulty, such as lack of cooperation, to support the A631 claim.
- Verify that no other diagnostic nuclear medicine procedure code is billed for the same patient on the same date to avoid claim rejection.
Effective: June 1, 2025
Consultations and Visits
Nuclear Medicine (63)
Consultations and Visits
Assessment
Evaluation must be on a non-emergent basis
Resulting in the cancellation or deferral of a planned diagnostic nuclear medicine procedure
Due to procedural difficulties, including lack of patient cooperation
If no other diagnostic nuclear medicine procedure is rendered
This code is specifically for instances where the specialist evaluates a patient on a non-emergent basis resulting in the cancellation or deferral of a planned diagnostic nuclear medicine procedure due to procedural difficulties, including lack of patient cooperation, if no other diagnostic nuclear medicine procedure is rendered.
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