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Billing code

A384A — Consultation And Management For Acute Cerebral Vascular Syndrome (acvs)

Acute stroke neurology consultation

A neurologist bills A384 for a consultation on suspected acute stroke, including IV thrombolysis and monitoring if needed.

Watch for: Only for a neurologist in a hospital with CT or MRI on site, within the thrombolysis window, with the referrer's billing number.

Code

A384A

Description

Consultation And Management For Acute Cerebral Vascular Syndrome (acvs)

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

Neurology consultation for suspected acute stroke (ACVS), including IV thrombolysis and monitoring if needed.

What it covers

A Consultation and Management for Acute Cerebral Vascular Syndrome (ACVS) is a service in which the neurologist provides all the elements of a consultation (A185) to a patient referred for suspected ACVS and, if needed, treats with intravenous thrombolysis and post-administration monitoring (A142).

Time beyond the first 30 minutes, when thrombolysis is given, is billed as K181 units. The in-patient listing is C384 (A142, A144).

Billing rules

• Only for patients seen within the IV thrombolysis eligibility window defined by the Canadian Stroke Best Practices (A143).
• Must be rendered in a hospital with CT or MRI on site (A143).
• Payable only to a specialist in Neurology (18), who must stay in constant attendance with the patient (A143).
• G521, G522, G523 and G391 are not payable with A384, C384 or K181 (A143).
• Record the start and stop times and the time of symptom onset in the chart, or it is not payable (A142).
• As a consultation, it needs a written request from the referring physician or nurse practitioner and a written report back (GP16).

Often billed with

• K181 for each 30-minute unit after the first 30 minutes when IV thrombolysis is given (A142).

Common rejections

• A4D: OHIP describes this as 'Invalid specialty for this service code': ACVS codes are payable only to a Neurology (18) specialist (A143).
• ARF: OHIP describes this as 'Missing Physician Referring Number': a consultation needs the referring physician's or nurse practitioner's billing number from the written request (GP16).

Related codes: K181, C384, A185, A180, C185

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Neurology (18), page A142. Payment rules A143.

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