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H002
H002 – Low birth weight baby care (uncomplicated) - initial visit
OHIP Obstetrics Code — CONSULTATIONS AND VISITS · Schedule of Benefits
H002 is the initial assessment for uncomplicated low birth weight baby care. As defined on page , low birth weight baby care is any assessment of a well newborn or infant weighing less than 2.5 kilograms at birth. This service is intended as the first visit for this condition and is claimed per baby.
When to Use
- Use H002 for the first assessment of a stable, uncomplicated newborn weighing under 2.5kg who does not require intensive care or complex management.
- Select H002 when performing the initial evaluation of a low birth weight infant who is being monitored as an outpatient or in a step-down nursery setting.
Common Pitfalls
- Do not bill H002 in conjunction with special visit premiums, as these are explicitly excluded by the Schedule of Benefits under GP69.
- Avoid using H002 for infants weighing 2.5kg or more; for those patients, standard assessment codes like A007 must be used instead.
- Claims will be rejected if H002 is submitted for a sick infant requiring intensive care, as this code is strictly reserved for uncomplicated, well-infant care.
Billing Tips
- Ensure the birth weight is clearly documented in the patient record to justify the use of H002 over standard assessment codes during Ministry audits.
- If the infant requires a subsequent visit, transition to H003 for follow-up care rather than repeating the initial H002 code.
Provider Fee$34.10
Specialist Fee$0.00
Surgical Assistant Fee$0.00
Anaesthetist Fee$0.00
Non-Anaesthetist Fee$0.00
Effective: April 1, 2025
Category
A. Consultations and Visits
Subcategory
CONSULTATIONS AND VISITS
Service Type
Assessment
Code Classes
Assessments
Age Restriction
Patient must be a newborn or infant (birth up to, but not including, 2 years of age).
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