1What Is the A814 OHIP Code?
A814 is an OHIP billing code designated for assessments requested by midwives or Aboriginal midwives when they encounter complex, obscure, or serious issues in their care of mothers or newborns. These assessments are typically conducted via video, providing a valuable resource for both midwives and families who might otherwise have to travel for specialized opinion.
Family physicians can bill for this code when they receive a written request from a midwife. This service ensures that patient care remains comprehensive and eliminates the need for patient travel during late pregnancy or early motherhood when challenges such as rising blood pressure in late pregnancy or poor feeding in a newborn arise.
The code may be overlooked if the documentation requirements are not fully understood or if it is confused with similar codes like A813. Ensuring comprehensive and documented correspondence with the midwife is essential to proper billing.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A914 | GP focused practice comprehensive consultation by Video | Check specialty listing | Comprehensive consultations for family practice delivered by video. |
| A006 | Repeat consultation | Check specialty listing | For follow-up consultations in family practice. |
| A010 | GP focused practice consultation by Video | Check specialty listing | Regular consultations in family practice delivered via video. |
| A011 | GP focused practice repeat consultation by Video | Check specialty listing | Follow-up consultations delivered via video in family practice. |
3Eligibility Requirements
To bill A814 under OHIP, the assessment must be requested in writing by a midwife or Aboriginal midwife due to the complex nature of the patient's condition. The request should be retained in the patient’s medical record. This service can be conducted via video but is not eligible for telephone delivery.
In urgent cases, requests can be verbal initially but must be followed by a written request.
- Maximum one A814 assessment per patient per physician per pregnancy.
- All findings must be communicated verbally to the requesting midwife and in writing to both the midwife and the patient’s primary care provider, if applicable.
4What Your Clinical Note Must Show
Ensure proper documentation is maintained for billing A814.
- Written request from a midwife retained in the patient's medical record.
- Assessment findings and recommendations must be communicated verbally to the midwife.
- Written report provided to the midwife and the patient’s primary care provider.
5Weak vs. Strong Note Examples
The strong note is detailed, documents specific clinical findings, outlines clear recommendations, and communicates comprehensively with all necessary parties, thereby meeting OHIP billing requirements.
Assess patient as requested by midwife. Blood pressure slightly elevated.
Discuss findings briefly with midwife. No serious concerns.
Conducted video assessment at midwife's request due to persistent elevated blood pressure in late pregnancy.
Found BP 140/90, advising close monitoring and potential intervention. Provided verbal update to midwife and completed written report for patient’s records. Recommendations include Biophysical Profile (BPP) if condition persists.
- Acquire BPP if condition persists.
- Discuss safety of home management versus hospitalization with patient and partner.
