Jaime (MDBilling.ca Support)How to bill K083 for follow-up/assessments effectively
IMPORTANT: The new virtual care funding framework set out in the PSA will take effect on December 1, 2022. Therefore, the temporary virtual code K083 will remain in place until November 30, 2022. See OHIP bulletin 220901 for more details.
As an extension to the automatic codes (A[][]XA) (designed for various disciplines to bill re/assessments quickly), we have designed a new automatic code A[][]VA, which resolves to service code K083 (Specialist consultation or visit by telephone or video) at the value of the equivalent in-person the assessment codes, rounded to the nearest $5.00.
Noted: A[][]VA follows the same rules in our system as A[][]XA
For example, under Medical Oncology (44), the automatic code for a virtual assessment service is A44VA. The algorithm for A44VA will bill K083A with quantities as follows:
|
Service |
In-person service Code |
Fee |
K083 Units |
K083 Fee |
|
Medical specific assessment |
A443 |
$79.85 |
16 |
$80.00 |
|
Complex medical specific re-assessment |
A441 |
$70.90 |
14 |
$70.00 |
|
Medical specific re-assessment |
A444 |
$61.25 |
12 |
$60.00 |
|
Partial assessment |
A448 |
$38.05 |
8 |
$40.00 |
Please note: A13VA is only available for physicians who are practicing solely as a general internist as it includes the value of the equivalent 12% Internal Medicine Office Assessment Premium
|
Service |
In-person service Code |
Fee with 12% premium |
K083 Units |
K083 Fee |
|
Medical specific assessment |
A133 ($79.85) |
$89.43 |
18 |
$90.00 |
|
Complex medical specific re-assessment |
A131 ($70.90) |
$79.41 |
16 |
$80.00 |
|
Medical specific re-assessment |
A134 ($61.25) |
$68.60 |
14 |
$70.00 |
|
Partial assessment |
A138 ($38.05) |
$42.62 |
9 |
$45.00 |
The automatic code A[][]VA is available for the following disciplines:
- Cardiology (60)
- Clinical Immunology (62)
- Community Medicine (05)
- Endocrinology & Metabolism (15)
- Gastroenterology (41)
- Geriatrics (07)
- Haematology (61)
- Infectious Disease (46)
- Internal And Occupational Medicine (13)
- Medical Oncology (44)
- Nephrology (16)
- Neurology (18)
- Physical Medicine & Rehabilitation (31)
- Radiation Oncology (34)
- Respiratory Disease (47)
- Rheumatology (48)
- General Surgery (03)*
- Neurosurgery (04)*
- OBGYN (20)*
- Orthopaedic Surgery (06)*
- Plastic Surgery (08)*
*Please refer to the rules of the automatic code A[][]XA for these disciplines as they are different from the other disciplines.
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