1What Is the A802 OHIP Code?
What is the A802 OHIP Billing Code?
The A802 OHIP billing code refers to an extended genetic assessment service provided by medical geneticists in response to requests from midwives or aboriginal midwives. This assessment is typically utilized when there is a need for complex genetic evaluations, comprehensive pedigree analysis, counseling on reproductive options, and the coordination of confirmatory testing in one session. The code is specifically designed for scenarios involving complex, obscure, or serious genetic concerns during pregnancy that require in-depth assessment beyond standard consultations.
A802 is particularly important for handling intricate prenatal findings that a midwife may identify, necessitating specialized evaluation to guide patient care effectively. It is crucial to adhere to the billing requirements and time documentation to ensure proper compensation for the specialist's expertise and time commitment.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A220 | Special genetic consultation | Unlimited, subject to general preamble assessment rules. | Covers non-extended special consultations by geneticists. |
| A223 | Extended special genetic consultation | Unlimited, subject to general preamble assessment rules. | Covers extended consultations in genetic assessments. |
| A225 | Consultation | Unlimited, subject to general preamble assessment rules. | Basic genetic consultations by specialists. |
| A226 | Repeat consultation | Unlimited, subject to general preamble assessment rules. | Used for follow-up consultations. |
3Eligibility Requirements
Eligibility Requirements for A802
- Patient Referral: The service must be requested in writing by a midwife or aboriginal midwife due to the complexity or seriousness of the patient's genetic concern.
- Direct Contact Time: The geneticist must spend a minimum of 90 minutes in direct contact with the patient.
- Service Frequency: A802 is limited to one service per patient, per physician, every 24 months.
- Written Findings: A report with findings, opinions, and recommendations must be submitted to the requesting midwife and the patient's primary care provider if applicable. Failure to do so will result in a reduced fee.
- Time Documentation: Start and stop times of the service must be recorded in the patient's permanent medical record to qualify for payment.
- Documentation: The request from the midwife must be retained in the patient's permanent medical record.
4What Your Clinical Note Must Show
Ensure accurate recording of service times.
- Record the start and end time of the consultation in the patient's medical record.
Maintain the requesting documentation from the midwife.
- Keep the written request from the midwife as part of the patient's permanent record.
Submit findings to relevant healthcare providers.
- Provide a written report to the midwife and the primary care provider.
5Weak vs. Strong Note Examples
The strong note clearly delineates the consultation duration, includes complete reporting instructions, and confirms all necessary documentation, ensuring compliance with billing requirements.
Patient seen for genetic issues. Consult initiated by midwife.
Conducted a detailed genetic assessment at the midwife's request for complex prenatal findings.
Assessment duration: 90 minutes.
Provided written recommendations and genetic counseling to both the midwife and primary care physician.
- Start and end times documented
- Referral and findings report stored in patient's records
