1What Is the A682 OHIP Code?
What is A682?
A682 is an extended special neurology consultation for complex cases requiring detailed evaluation. Instances include drug-resistant epilepsy, progressive neurodegenerative disorders, suspected functional neurological disorders, and complex neuromuscular diseases. Unlike standard consultations, A682 demands more time and clinical resources. Physicians often overlook this code for less complex cases, missing the higher reimbursement rate it permits when thoroughly justified.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A180 | Special neurology consultation | Variable | An intermediate consultation for specific neurological issues. |
| A185 | Consultation | Variable | Standard neurology consultation for general evaluations. |
| A186 | Repeat consultation | Variable | Follow-up consultation after an initial evaluation. |
| A385 | Limited consultation | Variable | Brief consultation for focused neurological issues. |
3Eligibility Requirements
Eligibility for A682
The A682 code is applicable when two distinct conditions are met:
-
Frequency: It is billable once per two consecutive 12-month periods for the same patient under the same physician for the same diagnosis. An exception permits two claims if the second occurs when the patient is a hospital inpatient or an Emergency Department patient, between 12 to 24 months from the first consultation.
-
Virtual Delivery: A682 can be rendered virtually but only through video conferencing (billed as A682A). Telephone consultations do not meet the criteria for A682 billing as per OHIP comprehensive virtual care services.
4What Your Clinical Note Must Show
Ensure the following elements are captured in the patient's medical record:
- Comprehensive patient history and examination.
- Details of prior treatment approaches and imaging if applicable.
- Documented clinical reasoning for extended consultation requirement.
- Proof of patient complexity that justifies extended consultation (e.g., differential diagnosis, necessity of long-term monitoring).
5Weak vs. Strong Note Examples
The strong note succeeds because it clearly outlines the complexity and necessity for the extended consultation, including prior treatments and multidisciplinary involvement, unlike the weak note which lacks specific details.
Patient presents with neurological concerns. Detailed history taken. Requires further investigation.
Patient presents with drug-resistant epilepsy. Previous trials of medication X, Y, and Z evaluated with inadequate control of seizures. Imaging reviewed with no clear surgical solution, necessitating a comprehensive seizure history reconstruction and multi-disciplinary team input before exploring surgical options.
- Extensive review of past treatment history.
- Complex clinical decision-making documented.
