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P013
P013 – Obstetrical anaesthesia
OHIP Plastic Surgery Code — OBSTETRICS · Schedule of Benefits
P013 is an anaesthesia service rendered for an obstetrical procedure. As defined in of the Schedule, the general anaesthesia service includes a pre-anaesthetic evaluation, the anaesthetic procedure, and post-anaesthetic follow-up. The fee is calculated by adding 6 basic units to the applicable time units and multiplying by the anaesthesiologist unit fee as per and . Extra units may be payable for specific patient conditions (e.g., age, BMI, ASA status) as listed on .
When to Use
- Use P013 for general anaesthesia services provided during obstetrical procedures, such as a Caesarean section, where the anaesthesiologist provides the full pre-anaesthetic evaluation, procedure, and post-anaesthetic follow-up.
- Use P013 when the anaesthetic service is distinct from the surgical procedure, as you cannot bill P013 if you are the surgeon performing the procedure on the same patient.
Common Pitfalls
- Failure to document the specific ASA physical status classification in the record, which is required to justify the addition of extra units like E022C, E017C, or E016C.
- Attempting to bill P013 for continuous conduction anaesthesia (e.g., epidural for labour analgesia), which is governed by different billing rules under GP95 rather than the standard P013 unit-based calculation.
- Incorrectly applying the E420 trauma premium to obstetrical cases, as this premium is strictly reserved for patients meeting specific Injury Severity Score (ISS) thresholds and is incompatible with other special visit premiums.
Billing Tips
- Always calculate the total fee by adding the 6 basic units to your time units before applying percentage-based premiums like E400C or E401C, rather than applying the percentage to the base unit fee alone.
- Ensure that if an emergency surgery occurs (ASA E), you bill the appropriate ASA level code (E022C, E017C, or E016C) in conjunction with E020C to capture the additional 4 units for emergency status.
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