1What Is the A084 OHIP Code?
A partial assessment, billed under OHIP code A084, is a limited type of patient evaluation undertaken by plastic surgeons. It involves documenting a brief history of the presenting complaint, performing a necessary physical examination, and offering appropriate advice to the patient. Clinically, this type of assessment is often used during follow-up visits to inspect healing wounds or to ensure the proper application of dressings.
Despite its straightforward nature, partial assessments can be frequently overlooked due to the assumption they're less significant or because comprehensive assessments seemed more appropriate. It's important for practitioners to recognize scenarios where a limited review is adequately reflective of the service rendered to avoid potential billing discrepancies.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A083 | Specific assessment | According to specialty and General Preamble | Detailed assessment that involves a more comprehensive evaluation. |
| C083 | Specific assessment | According to specialty and General Preamble | In-patient equivalent of a specific assessment. |
| C084 | Specific re-assessment | According to specialty and General Preamble | In-patient equivalent for a re-assessment service. |
| A935 | Special surgical consultation | Governed by the specialty listing rules | Comprehensive surgical consultation service. |
3Eligibility Requirements
Eligibility Requirements
- The partial assessment must include a recorded history of the presenting complaint, an appropriate physical exam, patient advice, and documentation.
- A084 can be billed more than once per day for different patients but must follow specialty-specific rules as outlined in the General Preamble and Plastic Surgery guidelines.
- Documentation for each partial assessment must include start and end times recorded in the patient’s medical record.
- This service may be delivered virtually as A084A, whether by video or telephone.
- For hospital in-patients, claim the equivalent code C084 for a similar partial re-assessment service.
- Not to be billed as part of a hospital or day care admission unless it constitutes the major pre-operative visit.
4What Your Clinical Note Must Show
Ensure the following elements are present:
- History of the presenting complaint
- Necessary physical examination details
- Advice given to the patient
- Start and end times of the service
5Weak vs. Strong Note Examples
The strong note provides specific details about the patient's condition, the care given, and advice that aligns with practice standards, whereas the weak note lacks detail and comprehensive advice.
Reviewed patient's wound. Healing well.
10:00 AM - 10:15 AM
Patient presented for follow-up of excisional biopsy wound on left forearm. Site inspected; dressing intact, no signs of infection or undue swelling.
Advised patient on wound care and signs of infection to watch out for, such as redness or discharge.
Recorded from 10:00 AM to 10:20 AM.
- Detailed description of the wound and healing progress
- Specific patient advice for self-care
- Exact timing of the service
