Billing code
A064A — Orthopaedic surgery partial assessment
Brief orthopaedic visit
An orthopaedic surgeon bills A064 for a partial assessment: history of the complaint, the exam needed, advice and a record.
Watch for: If your decision-to-operate visit is the same day as a Z-code procedure, no assessment before the procedure is payable.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $0.00 | $25.95 | $0.00 | $0.00 | $0.00 |
- Code
- A064A
- Description
- Orthopaedic surgery partial assessment
- FHO+ basket
- Not in the FHO+ base rate basket (Schedule 2 or 2B).
- Effective date
- Apr 1, 2026
- Termination date
- No end date
Explanation
Updated October 26, 2026
Partial assessment by an orthopaedic surgeon: history of the complaint, the exam needed, advice and a record.
What it covers
A064 is the Orthopaedic Surgery (06) partial assessment (A164). A partial assessment is a limited service: a history of the presenting complaint, the necessary physical exam, advice to the patient and an appropriate record (GP25).
Billing rules
- Specialists bill from the Consultations and Visits listing of their own specialty, here Orthopaedic Surgery (06) (GP9).
- Before a Z-code procedure (IOP), a partial assessment is the only assessment payable that day if your major pre-operative visit was in the past 12 months. If the major pre-operative visit is the same day, no other assessment before the IOP is payable (SP4).
- A minor procedure plus an unrelated, significant problem in another body system at the same visit: bill both the procedure and the assessment (SP4).
- Can be done by video or phone with an existing patient relationship; add K300A (video) or K301A (phone) (AJ1, A70).
- Detention (K001) can be added only after 30 minutes (GP29–GP30).
Often billed with
- A Z-code procedure done the same day (SP4).
- K001 detention, after the first 30 minutes (GP29–GP30).
Common rejections
- AT3: OHIP describes this as 'No patient-physician relationship': billed as virtual care (K300A/K301A) without an existing relationship, such as an in-person service by you in the past 24 months (A66).
Related codes: A063, A065, A066, Z222, Z223, K001
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Orthopaedic Surgery (06), page A164. Assessment rules GP25.
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