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K481 – Rheumatoid arthritis management by a specialist

OHIP Consultations and Visits Code — CONSULTATIONS AND VISITS · Schedule of Benefits

This is the service rendered by a specialist in Rheumatology who is most responsible for providing ongoing management of a patient with rheumatoid arthritis. This service includes all services related to the coordination, provision and documentation of ongoing management, including documentation of all medical record requirements, using a planned care approach.
Measurement of tender joint count;
Measurement of swollen joint count;
Physician and patient global assessment of disease activity;
Patient pain score;
Patient assessment of function (e.g. HAQ [Health Assessment Questionnaire] or [Short Form 36]);
Measurement of acute phase reactant (ESR or CRP); and
Calculation and recording of a pooled measure of RA disease activity (DAS-28 [Disease Activity Score 28], SDAI [Simplified Disease Activity Index], or CDAI [Clinical Disease Activity Index]).

Claims for K481 should only be submitted when the required elements of the service have been completed for the 12 month period for which K481 is claimed.

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