1What Is the C802 OHIP Code?
C802 represents the extended genetic assessment conducted upon a midwife's or aboriginal midwife's request, especially when a patient's condition is complex or serious. This service is typically provided to hospital in-patients and requires a minimum of 90 minutes of direct patient contact.
The context for using C802 often includes situations where multiple inherited conditions are possible, such as when an abnormal prenatal screen or significant family history necessitates comprehensive genetic counseling. This ensures that patients receive thorough testing options, reproductive advice, and familial risk evaluation prior to discharge.
This code is crucial but can be overlooked if the proper consultation documentation and time tracking are not meticulously recorded. Ensure all paperwork justifies the extended nature of the service.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A802 | Extended midwife or aboriginal midwife-requested genetic assessment | Identical rules to C802 for out-patient settings | Same service rendered in an out-patient setting. |
| A220 | Special genetic consultation | N/A | Provides a less extensive genetic consultation. |
| A223 | Extended special genetic consultation | N/A | Similar extended consultation in genetics but not specific to midwife request. |
| A225 | Consultation | N/A | General genetic consultation service. |
3Eligibility Requirements
The service under C802 is limited to being billed once per patient, per physician, in any 24-month period. To qualify, the assessment must be requested in writing by a midwife or aboriginal midwife, and this request must remain on record. A geneticist must spend at least 90 minutes in direct patient care, exclusive of other billable interventions.
Moreover, findings and recommendations must be shared in writing with both the requesting midwife and the patient's primary care provider. Failing to meet these eligibility requirements could reduce the amount payable. It is essential that the start and stop times of the assessment are clearly recorded in the patient's permanent medical record.
4What Your Clinical Note Must Show
Ensure the following elements are documented to secure full payment:
- Start and stop times of the genetic assessment.
- Written request from the midwife or aboriginal midwife.
- Written findings, opinions, and recommendations sent to the midwife and primary care provider.
5Weak vs. Strong Note Examples
The strong note succeeds by thoroughly recording all necessary details including time, written communication, and retention of the midwife’s request, ensuring compliance with all billing requirements. The weak note omits critical documentation, risking reduced payment.
Patient assessed for possible genetic disorders. Time spent with the patient not fully recorded. Feedback provided verbally to the midwife.
Conducted a 90-minute assessment focused on potential heritable conditions following an abnormal prenatal screen. Start time: 10:00 AM, End time: 11:30 AM.
The written request from the midwife is filed in the patient's record. Detailed findings and recommendations have been sent to both the midwife and the patient's primary care physician.
- Full timeline of assessment available.
- Written documentation maintained and shared appropriately.
