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OHIP Billing Tip #45 - Introducing New Automatic Code A[][]VA – Virtual Care Services (K083)

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How to bill K083 for follow-up/assessments effectively

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.

For more billing tips, please check out our Billing Tip Library.

Questions? Check under the HELP tab or send an email to support@mdbilling.ca

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