P005 – Antenatal preventative health assessment
OHIP Plastic Surgery Code — OBSTETRICS · Schedule of Benefits
The service rendered by the most responsible physician for conducting the initial review of antenatal risk. The review must examine all current psychosocial, genetic and medical issues affecting antenatal risk and must be documented in writing in the patient's permanent medical record. As an assessment, this service includes the specific elements of assessments as defined on of the Schedule.
When to Use
- Use P005 for the initial comprehensive antenatal risk assessment during the first prenatal visit, provided the physician is the most responsible provider.
- Apply this code when conducting the mandatory review of psychosocial, genetic, and medical risk factors that exceeds the scope of a standard A007 or A001 visit.
Common Pitfalls
- Billing P005 on the same day as a general assessment (A001/A007) will result in a rejection or payment at nil, as P005 is intended to be the primary assessment code for that encounter.
- Failure to explicitly document the psychosocial and genetic risk components in the chart will lead to clawbacks during an audit, as these are mandatory requirements for P005 eligibility.
Billing Tips
- Ensure you do not bill P005 in conjunction with other consultations or visits on the same day, as the Schedule of Benefits explicitly restricts this to prevent duplicate billing for the same encounter.
Effective: April 1, 2026
K. Obstetrics
OBSTETRICS
Assessment
Assessments, Obstetrics
The review must examine all current psychosocial, genetic and medical issues affecting antenatal risk and must be documented in writing in the patient's permanent medical record.
Female
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