All codes
A638
A638 – Partial Assessment
OHIP General Listings Code — Nuclear Medicine (63) · Schedule of Benefits
A partial assessment is a limited service that constitutes a history of the presenting complaint, the necessary physical examination, advice to the patient, and an appropriate record of the encounter.
When to Use
- Bill A638 for a focused history and physical examination of a new, acute complaint where a full assessment (e.g., A007) is not warranted.
- Use A638 when a patient presents with a specific symptom requiring a brief workup, such as a new rash or a localized musculoskeletal pain, and follow-up planning.
- A638 is appropriate for a limited assessment of a patient's condition prior to a minor procedure when the physician is not the one performing the procedure.
Common Pitfalls
- Billing A638 when the service provided is a minor assessment (A631/A632) for a cancelled or deferred procedure, as these codes are distinct.
- Submitting A638 for a patient already seen for the same complaint on the same day by the same physician, unless a second, unrelated diagnosis is clearly documented and addressed.
- Using A638 for an in-patient's hospital visit; this code is generally for out-patient or office settings, with specific exceptions for emergency/out-patient departments by physicians not on duty.
Billing Tips
- A638 can be billed with virtual care add-on code A638A if the partial assessment is conducted via video or telephone.
- Ensure the documentation clearly reflects a history, physical examination, advice, and a record of the encounter to support the A638 claim.
Provider Fee$0.00
Specialist Fee$40.00
Effective: June 1, 2025
Category
Consultations and Visits
Subcategory
Nuclear Medicine (63)
Service Type
Consultations and Visits
Code Classes
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 record.
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