A723 – Medical specific assessment - Occupational Medicine
OHIP General Listings Code · Schedule of Benefits
Specific assessment and medical specific assessment are services rendered by specialists, in a place other than a patient’s home, and require a full history of the presenting complaint and detailed examination of the affected part(s), region(s), or system(s) needed to make a diagnosis, and/or exclude disease, and/or assess function.
When to Use
- Bill A723 for a specialist's comprehensive evaluation of a new work-related injury, including detailed history and physical exam, to determine diagnosis and fitness for duty.
- Use A723 when a specialist performs a detailed assessment for a patient with a complex occupational exposure, requiring a full history and targeted examination to rule out specific occupational diseases.
- A723 is appropriate for a specialist's initial assessment of a patient with a suspected work-related musculoskeletal disorder, involving a thorough history and examination of the affected region to establish a diagnosis and treatment plan.
Common Pitfalls
- Billing A723 for routine follow-up visits; A724 (Medical specific re-assessment) or A721 (Complex medical specific re-assessment) are more appropriate for subsequent encounters.
- Submitting A723 for services provided in a patient's home; this code is explicitly for non-home settings as per GP23.
- Exceeding the limit of one A723 per patient per physician per 12 months without a different diagnosis or a 90-day elapsed period since admission, which will result in a reduced fee.
Billing Tips
- Ensure documentation clearly supports a 'specific assessment' by detailing the history of the presenting complaint and a focused examination of the affected system(s) to establish a diagnosis.
- When combining A723 with A721, remember the combined total is limited to 4 per patient per physician per 12 months; exceeding this will lead to a reduced fee for the excess claims.
Effective: April 1, 2026
Outpatient
Assessment
Full history of the presenting complaint and detailed examination of the affected part(s), region(s), or system(s) needed to make a diagnosis, and/or exclude disease, and/or assess function.
If rendered in the Emergency Department while the physician is not on duty, use this General Listing code rather than H-prefix codes.
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