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A813
A813 – Midwife or Aboriginal Midwife-Requested Assessment (MAMRA)
OHIP General Listings Code — CONSULTATIONS AND VISITS · Schedule of Benefits
An assessment of a mother or newborn provided by a physician upon the written request of a midwife or aboriginal midwife because of the complex, obscure or serious nature of the patient’s problem.
When to Use
- Bill A813 when a midwife requests a physician's assessment for a newborn with suspected sepsis, requiring a detailed in-person examination and diagnostic workup.
- Use A813 for an in-person assessment of a mother experiencing postpartum hemorrhage that is beyond the midwife's scope, necessitating physician intervention and management.
- A813 is appropriate when a midwife requests an urgent in-person assessment for a neonate with unexplained jaundice and lethargy, requiring physician evaluation and potential admission.
Common Pitfalls
- Submitting A813 without the required written request from the midwife, which is a mandatory documentation requirement for audits.
- Billing A813 for a routine follow-up visit that does not meet the criteria of a complex, obscure, or serious problem as requested by the midwife.
- Failing to document the verbal and written communication of findings and recommendations to the midwife and primary care provider, leading to potential claim rejections.
Billing Tips
- Ensure the written request from the midwife clearly outlines the reason for the assessment, specifying the complex, obscure, or serious nature of the maternal or newborn problem.
- Remember that A813 shares its usage limit of one per patient per pregnancy with A814; only one of these codes can be billed for the same patient within a single pregnancy.
Provider Fee$111.70
Effective: June 1, 2025
Category
A. Consultations and Visits
Subcategory
CONSULTATIONS AND VISITS
Service Type
Consultation/Assessment
Code Classes
Assessment
A814Midwife or Aboriginal Midwife-Requested Assessment (MAMRA) by VideoC813Midwife or Aboriginal Midwife-Requested Assessment (Hospital In-patient)A815Midwife or Aboriginal Midwife-Requested Special Assessment (MAMRSA)C815Midwife or Aboriginal Midwife-Requested Special Assessment (Hospital In-patient)
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