H131 – Minor assessment
OHIP Obstetrics Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A minor assessment rendered by an Emergency Department Physician (EDP) for an unscheduled patient. A minor assessment, as defined on page , includes one or both of the following: - a brief history and examination of the affected part or region or related to a mental or emotional disorder; or - brief advice or information regarding health maintenance, diagnosis, treatment and/or prognosis. The 'H' prefix codes are used by physicians working a designated shift in an emergency department or Hospital Urgent Care Clinic, or for services by an on-call physician where a special visit premium is not applicable, as detailed on page . This specific code applies to services rendered Monday to Thursday, between 17:00h and 24:00h, as listed on page .
When to Use
- Use H131 for minor, unscheduled ED presentations occurring Monday through Thursday between 17:00 and 24:00, such as a simple suture removal or a brief re-evaluation of a minor complaint.
- Use this code when the clinical encounter does not meet the complexity requirements of an intermediate assessment (H132) or a complex assessment (H133).
Common Pitfalls
- Billing H131 in conjunction with a special visit premium (e.g., K963 or K965) will result in an automatic rejection, as H-prefix codes are explicitly ineligible for these premiums.
- Attempting to bill H131 alongside other ultrasound services (excluding H100 or J149) will trigger a rejection, as EDPs are restricted from billing most ultrasound codes.
Billing Tips
- If you are performing in-patient interim admission orders for the same patient during the same shift, ensure you append H105 to your H131 claim to capture the additional service fee.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Assessment
Hospital and Institutional Consultations and Assessments, Assessments
With the exception of ultrasound guidance, (J149) or emergency department investigative ultrasound (H100), ultrasound services listed in this Schedule rendered by an Emergency Department Physician are not eligible for payment.
When any other service is rendered by the Emergency Department Physician in premium hours (and assessments may not be claimed), apply one of the following premiums per patient visit. H112: nights (00:00h to 08:00h); H113: daytime and evenings (08:00h to 24:00h) on Saturdays, Sundays or Holidays.
H114: - evenings (17:00h to 24:00h) on Mondays to Thursdays
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