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Billing code

C384A — Consultation And Management For Acvs

In-patient acute stroke consultation

Bill when a neurologist consults on a hospital in-patient with suspected acute stroke, giving intravenous clot-busting treatment and monitoring if needed.

Watch for: Record start and stop times and the time symptoms began in the chart, or it isn't payable.

Code

C384A

Description

Consultation And Management For 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) in a hospital in-patient, with IV thrombolysis and monitoring if needed.

What it covers

C384 is the in-patient listing for Consultation and Management for ACVS and is subject to the same conditions as A384 (A144).

The neurologist provides all the elements of a consultation (A185) for suspected ACVS and, if needed, treats with intravenous thrombolysis and post-administration monitoring. Time beyond the first 30 minutes with thrombolysis is billed as K181 (A142).

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, which can sit in the common hospital record, 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: A384, K181, C185, C180, A185

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Neurology (18), page A144. Conditions on A142–A143.

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