All codes
A197
A197 – Consultative interview with parent(s) or patient representative(s) of patient less than age 22
OHIP Consultations and Visits Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Consultative interview on behalf of disturbed patient (including report) - consultative interview with parent(s) or patient representative(s) of patient less than age 22.
Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon
A written report (including findings, opinions, and recommendations) must be sent to the referring physician, nurse practitioner or dental surgeon.
A copy of the written request for the consultation, signed by the referring physician, nurse practitioner or dental surgeon must be kept in the consulting physician’s medical record, except in the case of a consultation which occurs in a hospital, long-term care institution or multi-specialty clinic where common medical records are maintained. In such cases, the written request may be contained on the common medical record.
The request identifies the consultant by name and/or the specialty being consulted, the referring physician, nurse practitioner or dental surgeon by name and billing number, and identifies the patient by name and health number.
The written request sets out the information relevant to the referral and specifies the service(s) required.
The service must be personally rendered by the attending physician.
The appointment must be separately booked.
Age
consultative interview with parent(s) or representative(s) of patient less than age 22 (A183)
Usage limits
Limited to one service per two consecutive 12-month periods for the same diagnosis (general consultation limit).
Disturbed patient means someone experiencing a clinically significant disturbance in their cognition, emotional regulation, or behavior which limits their ability to provide a reliable and complete history.
If A197 and A198 (interview with patient < 22) are billed on the same day for the same patient, a minimum of 120 minutes of total time is required before K630 extension units become payable.
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