Billing code
K181A — Consultation And Management For Acute Cerebral Vascular Syndrome (acvs) - After First 30 Minutes, Must Include Intravenous Thrombolysis Therapy And Monitoring, Per 30 Minute Unit (or Major Part Thereof)
Stroke thrombolysis time add-on
Bill K181 per 30 minutes after the first 30 of an acute stroke consultation (A384 or C384) when IV thrombolysis is given.
Watch for: Neurology only, in constant attendance; record start, stop and symptom-onset times, maximum 6 units per day.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $0.00 | $90.00 | $0.00 | $0.00 | $0.00 |
- Code
- K181A
- Description
- Consultation And Management For Acute Cerebral Vascular Syndrome (acvs) - After First 30 Minutes, Must Include Intravenous Thrombolysis Therapy And Monitoring, Per 30 Minute Unit (or Major Part Thereof)
- FHO+ basket
- Not in the FHO+ base rate basket (Schedule 2 or 2B).
- Effective date
- Jun 1, 2025
- Termination date
- No end date
Explanation
Updated October 26, 2026
Add-on to an acute stroke (ACVS) consultation for each 30 minutes after the first 30, when IV thrombolysis is given.
What it covers
K181 is billed per 30-minute unit, or major part, after the first 30 minutes of a Consultation and Management for ACVS (A384 or C384). It must include intravenous thrombolysis therapy and monitoring (A142).
Billing rules
- Only for patients treated with IV thrombolysis as defined by the Canadian Stroke Best Practices, and seen within the eligibility window (A143).
- Limited to 6 units per patient per day (A143).
- Payable only to a specialist in Neurology (18), in a hospital with CT or MRI on site, while you stay in constant attendance (A143).
- G521, G522, G523 and G391 are not payable with K181 (A143).
- Record the start and stop times and the time of symptom onset in the chart, or it is not payable (A142).
Often billed with
- A384 or C384 consultation and management for ACVS (A142, A144).
Common rejections
- A4D: OHIP describes this as 'Invalid specialty for this service code': ACVS codes are payable only to a Neurology (18) specialist (A143).
- A3H: More units were billed than OHIP allows; K181 is limited to 6 units per patient per day (A143).
Related codes: A384, C384, A185, C185
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Neurology (18), page A142. Payment rules A143.
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