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B551

B551B551

OHIP Paediatrics Code · Schedule of Benefits

When to Use

  • B551 is appropriate when a physician provides a consultation for a patient with a suspected or confirmed diagnosis of a sexually transmitted infection (STI) and the patient is not presenting with acute symptoms requiring immediate management.
  • Use B551 for follow-up consultations to discuss STI test results, provide counselling on prevention, and manage treatment plans for patients diagnosed with STIs, provided no new acute symptoms have arisen.
  • This code is suitable for consultations where the primary focus is on STI screening for asymptomatic individuals at high risk, such as those with multiple partners or a history of previous STIs.

Common Pitfalls

  • Billing B551 for a patient presenting with acute symptoms of an STI (e.g., discharge, pain, lesions) is incorrect; A007 or other appropriate assessment codes should be used instead.
  • Submitting B551 when the patient requires a specific procedure related to STI management, such as a biopsy or complex wound care, is inappropriate; the procedure code should be billed.
  • Using B551 for routine follow-up of chronic conditions unrelated to STIs will lead to rejections; ensure the consultation's primary purpose is STI-related.

Billing Tips

  • Ensure the patient's chart clearly documents the reason for the consultation as STI-related, including screening, diagnosis discussion, or management of a confirmed STI.
  • If a patient presents with both STI concerns and unrelated acute issues, bill the most complex service separately; B551 may be appropriate for the STI component if it meets the criteria, alongside another assessment code for the acute issue.
Provider Fee$0.00

Effective: February 1, 2008

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