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H003
H003 – Low birth weight baby care - subsequent visit
OHIP Obstetrics Code — CONSULTATIONS AND VISITS · Schedule of Benefits
This service is a subsequent visit for an uncomplicated low birth weight baby. Per of the Schedule, "Low birth weight baby care is any assessment of a well newborn/infant weighing less than 2.5 kilograms at birth". This visit follows the initial assessment, which is claimed as H002.
When to Use
- Use H003 for routine follow-up assessments of a stable infant born under 2.5kg who does not require complex intervention.
- Use H003 for subsequent weight checks or monitoring of feeding progress in a well low-birth-weight infant after the initial H002 assessment.
Common Pitfalls
- Billing H003 for an infant who has developed complications or requires acute care, which should instead be billed as a standard office visit (A007).
- Claiming H003 for infants weighing 2.5kg or more at birth, as this code is strictly reserved for those meeting the low birth weight criteria.
- Submitting H003 for visits occurring after the infant has reached the age of 2 years, as the code is restricted to the newborn and infant period.
Billing Tips
- Ensure the birth weight is clearly noted in the patient's chart to justify the use of H003 over standard visit codes during an audit.
- Do not bill H003 in conjunction with other visit codes on the same day; it is intended as the primary assessment code for that encounter.
Provider Fee$16.90
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
Applicable to newborns (birth up to and including 28 days) and infants (from 29 days up to, and less than, 2 years of age).
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