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Billing code

A083A — Specific assessment – plastic surgery

Plastic surgery specific assessment

A plastic surgeon bills A083 for a full history of the presenting complaint and a detailed exam of the affected area.

Watch for: One per patient per physician per 12 months, two only for a clearly unrelated diagnosis; extras pay as a lesser assessment.

Code

A083A

Description

Specific assessment – plastic surgery

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

Plastic surgeon's specific assessment: full history of the presenting complaint and a detailed exam of the affected part, region or system.

What it covers

A specific assessment is a specialist's service, outside the patient's home, with a full history of the presenting complaint and a detailed exam of the affected part(s), region(s) or system(s) needed to make a diagnosis, exclude disease or assess function (GP23).

A083 is the plastic surgery general (A-prefix) listing. A plastic surgeon in hospital but not on ED duty who sees patients in the ED or out-patient department also uses the general listings (A181).

Billing rules

• Specific assessments are limited to 1 per patient per physician per 12 months (2 if the second visit has a clearly different, unrelated diagnosis); extras are paid as a lesser assessment (GP23).
• The major pre-operative visit (the visit where you decide to operate) is billed separately from the surgical fee, whenever it happened (SP2).
• Before a Z-code procedure (IOP): if your major pre-operative visit was in the prior 12 months, only a partial assessment is payable earlier that day; if the major pre-operative visit is that same day, no other assessment before the IOP is payable (SP4 §13).
• Can be done by video or phone with an existing relationship; add K300A or K301A (Appendix J, A70).

Often billed with

• A same-day procedure when you assess and treat an unrelated, significant problem in another body system (SP4 §12).

Common rejections

• AT3: Billed as virtual care (K300A/K301A) and OHIP found no existing patient-physician relationship, such as an in-person service by you in the past 24 months (A66).

Related codes: A084, A085, A086, A935, C083, C084

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Plastic Surgery (08), page A181; rules GP23.

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