Pre-dental/ Pre-operative Assessments are services required to provide history and physical exam information to the peri-operative team that will be assessing suitability for surgery and anaesthesia. Pre-dental/ Pre-operative assessments rendered by primary care physicians (General Family Practice/Paediatrics/Emergency Medicine) and Specialists are separately listed.
A904 is not eligible for payment:
a. where the service is rendered on the day of surgery;
b. to a physician practising in the following specialties: General and Family Practice (00) Paediatrics (26), and Emergency Medicine (12); or
c. unless it includes as a minimum the elements of a partial assessment.
An admission general assessment (C003) or general re-assessment (C004) is not eligible for payment for an elective surgery patient for whom a pre-dental/pre-operative assessment has already been claimed, within 30 days of this pre-dental/pre-operative assessment.
Only one of A904/C904/W904 or A903/C903/W903 is eligible for payment for the same patient for the same surgical procedure.
Please reference the billing pre-amble for these relevant interpretations of this billing code: