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Surgical specialties & anaesthesia
Anaesthesia OHIP billing codes
Anaesthesia consultations, after-hours and special visit premiums, the patient and procedure modifiers that add units, obstetric anaesthesia and regional blocks.
62 codes in 7 sections, fees from the current Schedule of Benefits. Every code the Schedule lists for specialty 01 is in the full Anaesthesia listing.
Consultations & assessments
- A015Consultation—
- A210Special anaesthetic consultationSpecial anaesthetic consultation (minimum 50 minutes)—
- A215Limited consultation for acute pain management in association with special visit to hospital in-patient—
- A016Repeat ConsultationRepeat consultation (Anaesthesia)—
- A013Specific Assessment - Anaesthesia—
- A014Partial AssessmentPartial assessment rendered by an anaesthesiologist.—
- A816Midwife or Aboriginal Midwife-Requested Anaesthesia Assessment (MAMRAA)—
- A818Midwife or Aboriginal Midwife-Requested Anaesthesia Assessment (MAMRAA) by Video—
Hospital visits
- C015ConsultationConsultation rendered to a hospital in-patient by an anaesthesiologist.—
- C210Special anaesthetic consultationA special anaesthetic consultation for a non-emergency hospital in-patient, which is subject to the same conditions as <billingCode>A210</billingCode>, requiring a minimum of 50 minutes of exclusive physician time with the patient.—
- C215Limited consultation for acute pain managementProvides for a limited consultation by an Anaesthesiologist for acute pain management for a non-emergency hospital in-patient. This service is subject to the same conditions as a limited consultation (<billingCode>A215</billingCode>).—
- C016Repeat consultation—
- C013Specific assessment—
- C014Specific re-assessmentSpecific re-assessment (Anaesthesia)—
- C012Subsequent Visit - First Five WeeksSubsequent visit - first five weeks—
- C017Subsequent visit by anaesthetist to patient in hospital or other institution, per daySubsequent visit by anaesthetist, sixth to thirteenth week inclusive (maximum 3 per patient per week)—
- C018Subsequent visit by consultant anaesthetist (hospital/institution)Concurrent care—
- C019Subsequent visit by anaesthetist to patient in hospital or nursing home, per daySubsequent visit by anaesthetist, hospital/nursing home, after 13th week.—
Patient modifiers — extra units
- E007CAdult aged from 70 to 79 years, inclusiveProvides 1 extra unit, added to the anaesthesia basic and time units, for administering an anaesthetic to a patient aged 70 to 79 years, inclusive. This modifier is part of the 'Extra Units' for anaesthesia as described on page <SectionPages>GP97</SectionPages>.—
- E018CAdult aged 80 years and olderProvides 3 extra units in addition to the basic and time units for an anaesthesia service when administered to a patient aged 80 years or older.—
- E009CAnaesthetic extra units - infant 29 days to 1 yearProvides 4 extra units, in addition to basic anaesthetic units, for administering an anaesthetic to an infant aged 29 days up to and including 1 year old.—
- E014CAnaesthetic for newborn to 28 days`<billingCode>E014C</billingCode>` provides 5 extra units to the anaesthesia calculation when administering an anaesthetic to a newborn patient from birth up to and including 28 days of age.—
- E019CAnaesthetic extra units for infant or child from 1 year to 8 years of ageAdds 2 extra units to the anaesthesia fee when administering an anaesthetic to an infant or child aged 1 to 8 years inclusive.—
- E021CAnaesthesia for premature newborn less than 37 weeks gestational ageProvides 9 extra units, in addition to basic and time units, for an anaesthesiologist administering anaesthesia to a premature newborn of less than 37 weeks gestational age.—
- E010CAnaesthetic extra units for patient with BMI > 40An additional 2 units payable to the anaesthesiologist when administering an anaesthetic to a patient with a Body Mass Index (BMI) greater than 40.—
- E016CASA V – moribund patient not expected to live 24 hours with or without operationProvides 20 extra units to an anaesthesia service for an ASA V moribund patient who is not expected to live for 24 hours, with or without an operation.—
- E017CASA IV – patient with incapacitating systemic disease that is a constant threat to life`<billingCode>E017C</billingCode>` provides 10 extra anaesthesia units for administering an anaesthetic to a patient with an incapacitating systemic disease that is a constant threat to life, as defined by ASA Physical Status IV.—
- E022CASA III - patient with severe systemic disease limiting activity but not incapacitatingAdds 2 extra units to an anaesthesia service for a patient classified as ASA III (severe systemic disease limiting activity but not incapacitating).—
- E020CASA E - emergency surgeryProvides 4 extra anaesthesia units when anaesthesia is administered for emergency surgery (commencing within 24 hours of booking) to a patient with ASA Physical Status III, IV, or V.—
Procedure modifiers & services
- E011CPatient in prone position during surgeryProvides 4 extra anaesthesia units when a patient is in a prone position during surgery.—
- E024CPatient in sitting position during surgery, greater than 60 degrees uprightAn anaesthesia premium providing 4 extra units, in addition to basic and time units, when a patient is in a sitting position greater than 60 degrees upright during surgery.—
- E025CUnanticipated massive transfusionProvides 10 extra anaesthesia units for managing an unanticipated massive transfusion, defined as the transfusion of at least one blood volume of red blood cells during a surgical procedure.—
- E012CMalignant hyperthermia managementProvides 5 extra units for an anaesthesia service administered to a patient with known or suspected susceptibility to malignant hyperthermia, where the anaesthetic requires a full malignant hyperthermia setup and management.—
- E013CAnaesthetic management for emergency relief of acute upper airway obstructionA modifier that replaces the standard basic units with 10 units when providing anaesthetic management for the emergency relief of acute upper airway obstruction.—
- E023CAnaesthesia service for ocular surgery, cystoscopy, and examination under anaesthesiaAnaesthesia service (deep sedation, general or regional) for specified ocular surgeries, cystoscopies, and examinations under anaesthesia. Payment is calculated as 6 basic units plus time units, and it replaces the standard anaesthesia fee for these procedures.—
- E032CAnaesthesia service for colonoscopy and sigmoidoscopyProvides anaesthesia for specific colonoscopy and sigmoidoscopy procedures. This service, billed by the anaesthesiologist, is calculated as 4 basic units plus time-based units and replaces standard anaesthesia billing for these procedures.—
- E030CProcedural sedationAnaesthesia service for procedural sedation in support of nerve block procedures performed by another physician. The service is compensated with 4 basic units plus time units, but is not eligible for extra anaesthesia units for patient age or condition.—
- E031CGeneral anaesthesia or deep sedationGeneral anaesthesia or deep sedation provided in support of nerve block procedures performed by another physician. This service is valued at 4 basic units plus applicable time units.—
- E001CSecond anaesthesiologistPayable for a second anaesthesiologist when their services are necessary in the interest of the patient. The fee is based on 6 basic units plus time units for the duration of assistance.—
- E005CReplacement anaesthesiologistService billed by a replacement anaesthesiologist who takes over for the original anaesthesiologist during a surgical procedure or delivery, excluding continuous conduction anaesthesia. The fee is based on 6 basic units plus time units for the duration of attendance.—
- E002CHypothermia used by anaesthesiologistReplaces the listed basic units for a surgical procedure with 25 units when hypothermia is used by the anaesthesiologist in procedures not otherwise specified as requiring it.—
- E006CCancelled Surgery - Anaesthesia ServicesPayable when an anaesthetic has begun but the surgical operation is cancelled prior to its commencement. The fee is calculated based on 6 basic units plus applicable time units.—
Obstetric anaesthesia
- P013Obstetrical anaesthesiaAnaesthesia service for an obstetrical procedure. The fee is calculated based on 6 base units plus time units.—
- P014CContinuous conduction anaesthesiaThis anaesthesia service is for the introduction of a catheter for labour analgesia, which includes the first dose of medication and may include a combined spinal-epidural injection. It is valued at 7 basic units as part of continuous conduction anaesthesia for obstetrics.—
- P016CMaintenance of obstetrical epidural anaesthesiaTime units for the maintenance of obstetrical epidural anaesthesia for labour analgesia. Calculated as 1 unit per half-hour of maintenance time, with a maximum of 12 units.—
- E100CAttendance at deliveryTime-based anaesthesia service for constant attendance at a delivery, calculated as 4 base units plus 1 time unit for each quarter-hour of attendance. Requires documentation of start and stop times.—
Acute pain & regional blocks
- G060Peripheral nerve block, majorA major peripheral nerve block for acute pain management, such as a block of the radial, median, ulnar, femoral, or sciatic nerve, a paravertebral block, an ankle block, or a fascia iliaca block.$55.00
- G061Peripheral nerve block, minorA minor peripheral nerve block for acute pain management, including specific nerve blocks like ilioinguinal, intercostal, or TAP block. This service is limited to a maximum of 4 services per patient, per physician, per day.$30.00
- G260Major plexus blockA procedure for the block of a major nerve plexus such as the brachial, lumbar, sacral, deep cervical, or a combined 3-in-1 block which must include the femoral, obturator, and lateral femoral cutaneous nerves.$80.00
- G224Nerve block by same physician performing the procedurePayable for a major or minor peripheral nerve block, major plexus block, neuraxial injection, or intrapleural block for post-operative pain control with a duration of action over 4 hours, when rendered by the same physician performing the main procedure.$15.55
- G218Ilioinguinal and iliohypogastric nerves blockA percutaneous nerve block injection targeting the ilioinguinal and iliohypogastric nerves.$54.65
- G219Infraorbital nerve blockA percutaneous injection for an infraorbital nerve block.$34.20
- G220Intercostal nerve blockA percutaneous nerve block for a single intercostal nerve. Use <billingCode>G221</billingCode> for each additional intercostal nerve block performed during the same session.$34.20
- G221Intercostal nerve - additionalThis service is for each additional intercostal nerve block performed after the initial block, which is billed using billing code <billingCode>G220</billingCode>.$16.95
- G231Somatic or peripheral nerves not specifically listed - one nerve or siteProvides for a percutaneous nerve block of a single somatic or peripheral nerve or site that is not otherwise specified in the Schedule of Benefits.$34.10
- G250Maxillary or mandibular division of trigeminal nerveA percutaneous nerve block for the maxillary or mandibular division of the trigeminal nerve.$75.10
- G125Caudal/lumbar epidural with catheterA procedure for acute pain management involving the placement of a catheter into the caudal or lumbar epidural space for continuous or repeated administration of medication.$100.00
How to use this anaesthesia code set
This is a working list, not the whole Schedule. It carries the codes the Ontario Schedule of Benefits ties to anaesthesia (specialty 01) — its own consultation and assessment codes, in-patient visits, premiums and the diagnostics or procedures that make up most of a day — sectioned the way a shift sheet reads. Codes open to every specialty that a anaesthesia physician also bills (general assessments, forms, special visit premiums) live in the Family Practice and Special visit premiums sets.
Each code links to its full Schedule entry: fee history, restrictions, required diagnoses and the codes it can or cannot be billed with. Fees shown are the current provider or specialist fee; percentage premiums show the percentage they add to the base service.
Common questions
Which consultation or assessment code does anaesthesia bill?
The consultations & assessments section of this set starts with A015 (Consultation). 8 codes are listed in that section.
What is in the Anaesthesia code set?
62 OHIP billing codes across 7 sections: Consultations & assessments; Hospital visits; After-hours & special visit premiums; Patient modifiers — extra units; Procedure modifiers & services; Obstetric anaesthesia; Acute pain & regional blocks. Anaesthesia consultations, after-hours and special visit premiums, the patient and procedure modifiers that add units, obstetric anaesthesia and regional blocks.
Are these the current OHIP fees?
Fees are read from the current Ontario Schedule of Benefits for Physician Services and refreshed hourly. Claims are paid at the fee in force on the service date, so always confirm the effective date on the code page.
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