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MDBilling - Billing Patient Reviews Effectively - Automatic Code (A[][]XA)
MDBilling - Billing Patient Reviews Effectively - Automatic Code (A[][]XA)
Sophia Jarvi avatar
Written by Sophia Jarvi
Updated over 6 months ago

Billing Patient Reviews Effectively - Automatic Code (A[][]XA)

By using MDBilling.ca’s software automation you can save time, improve accuracy, and ultimately, maximize your monthly revenue.
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​Important: please familiarize yourself with the Schedule of Benefits, and how the automation codes work. If you are not sure, do not use the automation codes.
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RE/ASSESSMENTS (A[][]XA) – "Patient Review" or "Follow Ups"

The MDBilling.ca automation allows for a physician to bill a single code for a “follow up”, and our software will automatically choose the highest paying assessment based on existing codes previously billed in our database. The algorithm will choose the highest paying re/assessment code first, and subsequently bill assessment codes in decreasing fee value, taking into account that each re/assessment code has a limit of the number of times it can be billed per every 12 months, as per the rules from the OHIP Schedule of Benefits (section GP14-16).

This automatic code is available for the following disciplines:

Available disciplines

Automation rules (replace [][] with your 2 digit specialty):

  • 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)

  • Medical Specific Assessment:
    ​A[][]3 max of 1 per 12 months, or 2 if the second visit is an unrelated diagnosis.

  • Complex Medical Specific Re-Assessment:
    ​A[][]1 max of 4 per 12 months, or any combination of A[][]3+A[][]1 to a max of 4 per 12 months

  • Medical Specific Re-Assessment:
    ​A[][]4 max of 2 per 12 months

  • Partial Assessment:
    ​A[][]8 thereafter

  • General Surgery (03)

  • Neurosurgery (04)

  • OBGYN (20)

  • Orthopaedic Surgery (06)

  • Plastic Surgery (08)

  • Specific Assessment:
    ​A[][]3 max of 1 per 12 months, or 2 if the second visit is an unrelated diagnosis.

  • Partial Assessment:
    ​A[][]4 thereafter

HOW TO USE:

Simply use the automatic code: A[][]XA (replace [][] with your 2 digit specialty), and our system will maximize your follow-up billings for you.

As an example:

  • Internal Medicine (13), the automatic code for Re/Assessment is: A13XA

  • Cardiology (60), the automatic code for Re/Assessment is: A60XA

  • Medical Oncology (44), the automatic code for Re/Assessment is: A44XA

  • Hematology (61), the automatic code for Re/Assessment is: A61XA

  • Respirology (47), the automatic code for Re/Assessment is: A47XA

You no longer have to determine which re/assessment code to bill. Just bill A[][]XA and we will automatically choose the correct code for you.

Please note the automation code only works for “A” prefix codes, but not with “C” prefix codes.

You can find your two-digit specialty under:
PREFERENCES - MY DETAILS - Specialty (see screenshot below)

IMPORTANT NOTE:

When billing A[][]XA with Chronic Disease Assessment Premium (E078A), please take the following steps:

  1. Add the automatic code A[][]XA first and SAVE the claim

  2. Once our software resolves the automatic code, you can then add the E078A and SAVE the claim. The premium will then be automatically attached to the assessment code, which allows the proper fee to be calculated.

Please find more automation codes by logging into our portal -> HELP -> “Automation Codes”.

There is also a video tutorial that teaches you how to use Automation OHIP Code
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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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