K032

PDF page 42 / GP28

FIRST VISIT BY PRIMARY CARE PHYSICIAN AFTER HOSPITAL DISCHARGE
  E080 First visit after hospital discharge premium, to other service
          listed in payment rule 5 below ..................................... add        25.90
      Payment rules:
      1.Subject to payment rules 2 through 5, E080 is only eligible for payment for a visit with the
        patient's primary care physician in the physician’s office or the patient’s home within two
        weeks of discharge following in-patient admission to an acute care hospital.
      [Commentary:
      This premium is not payable for visits rendered to patients in locations other than the
      physician's office or patient's home. As such, the premium is not payable for services rendered
      in places such as Nursing Homes, Homes for the Aged, chronic care hospitals, etc.]
      2.E080 is not eligible for payment if the admission to hospital was for the purpose of obstetrical
        delivery unless the mother required admission to an ICU during the hospital stay.
      3.E080 is not eligible for payment if the admission to hospital was for the purpose of newborn
        care unless the infant required admission to a NICU during the hospital stay.
      4.E080 is not eligible for payment if the admission to hospital was for the purpose of performing
        day surgery.
      5.E080 is only eligible for payment when rendered with the following services:
        A001, A003, A004, A007, A008, A261, A262, A263, A264, A888, A900, K004–K008, K013,
        K014, K022, K023, K028-K030, K032, K033, K037, K623, P003, P004, P008.

PDF page 186 / A58

K032 Specific neurocognitive assessment.......................................     80.00
     [Commentary:
     Examples of neurocognitive assessment batteries which would be acceptable are the short
     form of the Behavioral Neurology Assessment (BNA) or the Dementia Rating Scale (DRS). The
     Mini-Mental State Examination ("Folstein") test is not considered acceptable for this purpose.]
    Extended specific neurocognitive assessment
      An extended specific neurocognitive assessment is an assessment of neurocognitive function
      rendered personally by the physician where all of the following requirements are met:
     a. test of memory, attention, language, visuospatial function and executive function;
     b. a minimum of 46 minutes (consecutive or non-consecutive) must be dedicated exclusively to
        this service (including administration of the tests and scoring) and must be completed on the
        same day; and
     c. the start and stop time(s) must be recorded in the patient's medical record.
 K042 Extended specific neurocognitive assessment .......................             140.20
     Payment rules:
     1.K042 is only eligible for payment to specialists in one of the following: Geriatrics (07),
       Neurology (18), and Psychiatry (19).
     2.Only one of K032 or K042 is eligible for payment to the same physician, same day.
     [Commentary:
     Examples of extended neurocognitive assessment batteries which would be acceptable, where
     the minimum time requirement has been met, are the Toronto Cognitive Assessment (TorCA) or
     the Behavioral Neurology Assessment-short form in addition to the Montreal Cognitive
     Assessment (BNA-SF + MOCA) or the Behavioral Neurology Assessment-short form in
     addition to the Frontal Assessment battery (BNA-SF + FAB). Note that for K042, MOCA or
     BNA-SF or FAB alone is not a sufficient neurocognitive assessment battery for payment
     purposes.]

Master, record 2910. Record Layout PDF, page 1.

K03220260401999999990000080000000000000000000000000000000000000000000000000

Auxiliary master fields are preserved as raw scaled values. The linked layout calls them zero-filled, but this edition contains non-zero values. They are not presented as final dollar fees or PDF units.