1What Is the A662 OHIP Code?
The A662 OHIP billing code represents an extended special pediatric consultation service in an office or outpatient clinic setting. This code is reserved for intensive consultation efforts where a pediatric patient presents with complex, multi-system conditions. Examples include medically complex children with no single subspecialist, cases of failure to thrive, or syndromic children needing interdisciplinary plans.
Despite the provision for comprehensive care, A662 is commonly underutilized or incorrectly billed due to administrative errors, especially missing documentation of consultation start and stop times, which are critical for full reimbursement. Physicians should ensure the service is rendered only once per patient per year, per physician.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A260 | Special paediatric consultation | As needed | Standard specialized consultation for pediatric patients. |
| A265 | Consultation | As needed | General pediatric consultation not involving the complexity of A662. |
| A266 | Repeat consultation | As needed | Follow-up consultation post an initial consult. |
| A565 | Limited consultation | As needed | Brief consultation for straightforward cases. |
3Eligibility Requirements
To bill OHIP for the A662 extended special pediatric consultation, services must meet specific eligibility criteria:
- Maximum Frequency: One per patient, per physician, within a 12-month period.
- Documentation: Start and stop times must be recorded in the patient's permanent medical record. Failure to do so will result in payment being reduced to a lesser fee.
- Virtual Delivery: Eligible for billing as A662A when provided via video. Telephone consultations are not eligible.
- Hospital In-Patient: For in-patient scenarios, the equivalent code is C662.
4What Your Clinical Note Must Show
Ensure the following details are documented clearly to avoid fee reduction:
- Start and stop time of the consultation.
- Relevant clinical findings and patient history.
- Consultation conclusions and recommended care plan.
5Weak vs. Strong Note Examples
The strong note provides comprehensive details, including times and specific findings, ensuring compliance with OHIP documentation requirements.
Consultation conducted. Discussed patient case and potential treatment plans.
Extended consultation with complex case management completed. Details include:
- Start time: 10:00 AM, End time: 11:30 AM
- Reviewed patient's multi-system conditions: gastrointestinal, endocrine, cardiac.
- Coordinated with other subspecialties for a comprehensive care plan.
- Addressed potential psychosocial factors contributing to failure to thrive.
