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V406

V406V406

OHIP Other Code · Schedule of Benefits

When to Use

  • Use V406 for the initial assessment of a patient with a suspected or confirmed diagnosis of dementia or cognitive impairment when a comprehensive evaluation is performed.
  • Apply this code when conducting a formal cognitive assessment that requires significant time and clinical synthesis, distinguishing it from a standard A007 intermediate assessment.

Common Pitfalls

  • Billing V406 in conjunction with a standard office visit code like A007 on the same day is generally considered unbundling and will lead to rejection.
  • Failing to document the specific cognitive screening tools used or the clinical rationale for the assessment often leads to recovery during Ministry audits.

Billing Tips

  • Ensure your documentation clearly supports the complexity of the cognitive evaluation to justify the higher fee compared to routine assessment codes.
Provider Fee$80.00

Effective: March 1, 2025

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