A927 – Allergy FPA
OHIP General Listings Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Focused practice assessment (FPA) rendered by a GP/FP physician with additional training and/or experience in allergy. The assessment must satisfy, at a minimum, all of the requirements of an intermediate assessment.
When to Use
- Bill A927 for a comprehensive allergy assessment by a GP/FP with specialized allergy training, including a detailed history of allergic reactions, relevant physical exam (e.g., skin, respiratory), and development of a management plan.
- Use A927 when a patient requires an in-depth evaluation for suspected environmental allergies (e.g., pollen, dust mites) that goes beyond a standard intermediate assessment (K005), involving specific allergy-focused history and examination.
- A927 is appropriate for assessing complex medication allergies where a thorough history of reactions, cross-reactivity, and potential desensitization strategies are discussed and documented.
Common Pitfalls
- Billing A927 when the encounter is primarily for acute allergy management (e.g., prescribing an antihistamine for a mild rash) rather than a comprehensive assessment; consider K005 or K013 instead.
- Submitting A927 without ensuring all components of an intermediate assessment (K005) are met and documented, as A927 requires these as a minimum baseline.
- Billing A927 on the same day as another visit code (e.g., K005, K013, or any other consultation/assessment/visit/counselling service) to the same patient, which will result in rejection of one of the services.
Billing Tips
- Ensure your documentation clearly supports the 'focused practice assessment' aspect, detailing the allergy-specific history, examination findings, and the rationale for the assessment beyond a standard intermediate visit.
- Remember that A927 is eligible for a 15% Age Premium (AGE_PREMIUM_65) if the patient is 65 years or older, provided all other eligibility criteria for the premium are met.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Consultations and Visits
Assessment
Must satisfy all requirements of an intermediate assessment: history of the presenting complaint(s), inquiry concerning, and examination of the affected part(s), region(s), system(s), or mental or emotional disorder as needed to make a diagnosis, exclude disease, and/or assess function.
A927A is listed in Appendix J as a service eligible for virtual care (video).
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