1What Is the A775 OHIP Code?
A comprehensive geriatric consultation, billed under A775, is designed for detailed assessment of older adults. This service is typically rendered to evaluate cognitive impairments, risk of falls, or medication reviews, where a thorough assessment is completed in a single visit.
These consultations require a minimum of 75 minutes of direct patient contact and are meant for patients aged 65 or over, or any age if assessed for dementia. Missing this billing opportunity often occurs due to failure in recording specific time details or misunderstanding frequency limits.
Clinically, this consultation helps in the holistic assessment and management of the elderly, streamlining care and addressing multi-system involvement often seen in geriatric populations.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A070 | Consultation in association with special visit to a hospital | Frequency based on specific patient conditions and site of service | Used when consulting in conjunction with a special hospital visit for geriatric patients. |
| A075 | Consultation | General geriatric consultations as per patient needs | Standard consultation for a geriatric assessment. |
| A076 | Repeat consultation | When a follow-up consultation is needed | Used for additional consultations after the initial assessment. |
| A375 | Limited consultation | Used in cases requiring brief targeted assessments | Applicable for specific issues needing quick evaluation. |
3Eligibility Requirements
To be eligible for billing under A775, the consultation must involve:
- The patient being at least 65 years old or the consultation being conducted for dementia assessment.
- Direct contact time with the patient for a minimum of 75 minutes, excluding other billable services.
- Proper documentation, including start and stop times recorded in the patient's permanent medical record.
- Compliance with frequency limits: Only one service per two consecutive 12-month periods for the same patient and diagnosis. Exceptions allow a second service under specific conditions involving inpatient care more than 12 but less than 24 months after the first.
4What Your Clinical Note Must Show
Precise start and stop times for the consultation must be documented.
- Record in the patient's permanent medical record or chart.
- Ensure accuracy to meet the minimum 75-minute requirement.
Keep a written request from the referring practitioner in your records.
- Include details of the consultant and referring practitioner.
- Must align with the complexity or seriousness of the case.
5Weak vs. Strong Note Examples
The strong note clearly documents the specific start and stop times, detailed assessments, and recommendations, thus fulfilling billing requirements. The weak note lacks essential details regarding consultation specifics and timing.
Consultation conducted with patient discussing symptoms. Assessment made.
Conducted comprehensive geriatric consultation starting at 10:00 AM and ending at 11:30 AM. Discussed patient's cognitive concerns and medication regimen in detail.
- Assessments performed: cognitive function tests, fall risk evaluation, medication review.
- Recommendations: Adjustments to current prescriptions and follow-up plan suggested.
