1What Is the A184 OHIP Code?
What is A184?
A184 is the OHIP billing code for a medical specific re-assessment performed by neurologists. This service is typically provided in an office or outpatient setting to review a patient's progress or response to a treatment regimen. For instance, the code is relevant when assessing seizure frequency after a medication adjustment or tracking the recovery of a peripheral nerve deficit.
This code applies to follow-up visits aimed at addressing a specific neurological problem rather than performing a comprehensive examination. It facilitates ongoing management and decision-making in cases where a patient's condition has been previously evaluated, ensuring that treatment plans are effectively adjusted as necessary.
Clinicians may overlook this code when they fail to distinguish between a full, initial assessment and a targeted re-assessment, leading to potential billing inaccuracies.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A183 | Medical specific assessment | As per need, initial specific assessment. | Typically billed for an initial comprehensive neurological assessment requiring detailed evaluation. |
| C183 | Medical specific assessment | As per need, hospital setting initial specific assessment. | Used for initial assessments in hospitalized patients. |
| W184 | General re-assessment of patient in nursing home | Regular re-assessment as per patient's clinical need. | Billed when conducting general re-assessments in a nursing home setting. |
| A181 | Complex medical specific re-assessment | As required, for complex cases needing comprehensive evaluation. | Used for re-assessments requiring a more intensive evaluation than A184. |
3Eligibility Requirements
Eligibility Requirements
According to the OHIP Schedule of Benefits, the A184 code can be billed by neurologists for a medical specific re-assessment in office or outpatient settings. Key eligibility criteria include:
- Service Setting: Conducted outside of the patient's home.
- Documentation: The physician must record the time when the insured service started and ended in the patient's permanent medical record or chart as per General Preamble GP7.
- Virtual Delivery: A184 may be provided virtually through video or telephone as A184A, under the eligible comprehensive virtual care services guideline.
- Hospital Equivalent: C184 is used for hospital in-patient services equivalent to A184.
Ensure all criteria are met to qualify for billing this code.
4What Your Clinical Note Must Show
Ensure accurate documentation of service duration.
- Start and end times must be recorded in the patient's permanent record.
Re-assessment must be conducted outside the patient's home.
- Applicable in office or outpatient clinic settings.
Include notes for virtual re-assessments conducted via video or telephone.
- Document the platform used and verify compliance with guidelines.
5Weak vs. Strong Note Examples
The strong note clearly outlines the focus of the re-assessment, describes adjustments made, and includes accurate time documentation, which are missing in the weak note.
Patient seen for follow-up, discussed seizure control. No time recorded.
Follow-up re-assessment for seizure frequency post-dose adjustment.
- Reviewed patient's medication adherence.
- Adjustments to current treatment plan based on patient history and examination.
- Service duration: 10:00 AM to 10:30 AM documented.
