A800 – Genetics Consultation
OHIP General Listings Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Midwife or Aboriginal Midwife-requested genetic assessment
When to Use
- Bill A800 when a midwife requests a genetic assessment for a patient with a family history of a specific genetic disorder, and the assessment involves reviewing existing records and providing a written opinion.
- Use A800 for a genetic assessment initiated by an Aboriginal Midwife concerning a patient with a suspected genetic condition identified during prenatal screening, requiring a specialist's interpretation and report.
Common Pitfalls
- Failure to retain the written request from the midwife in the patient's chart will result in the claim being reduced to a lesser assessment fee.
- Not documenting the start and stop times of the genetic assessment service in the patient's medical record can lead to payment issues.
- Omitting to send the written findings, opinions, and recommendations to both the referring midwife and the patient's primary care physician or nurse practitioner will reduce the payable amount.
Billing Tips
- Ensure the written report clearly outlines the geneticist's findings, opinions, and recommendations to satisfy the documentation requirements.
- Verify that the referral is specifically from a midwife or Aboriginal Midwife; physician referrals should use different consultation codes like A005.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Genetics
Consultation
The written request from the midwife or aboriginal midwife must be retained on the patient’s permanent medical record, or the amount payable for the service will be reduced to a lesser fee.
The service is eligible for payment only if start and stop times of the service are recorded in the patient's permanent medical record.
The geneticist must submit his/her findings, opinions and recommendations in writing to both the midwife or aboriginal midwife and the patient’s primary care physician or nurse practitioner, if applicable, or the amount payable for the service will be reduced to a lesser fee.
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