H153 – Multiple systems assessment
OHIP Obstetrics Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A multiple systems assessment is an assessment rendered by an Emergency Department Physician working in a hospital emergency department or Hospital Urgent Care Clinic for an unscheduled patient. The service requires a history of the presenting complaint and examination of multiple body parts or systems as needed to make a diagnosis, exclude disease, and/or assess function. The “H” prefix listings apply when a full- or part-time Emergency Department Physician is working for a pre-arranged designated period of time or shift, or for services rendered by an on-call physician where the service does not qualify for claiming a special visit premium. This service is specifically for care provided on Saturdays, Sundays, and Holidays between 08:00h and 24:00h.
When to Use
- Use H153 for unscheduled patients presenting to the ED on weekends or holidays between 08:00h and 24:00h when a multiple systems assessment is required.
- Select H153 when the clinical presentation necessitates an examination of multiple body systems to rule out disease, distinguishing it from the single-system focus of H112 or H113.
Common Pitfalls
- Billing H153 in conjunction with special visit premiums (e.g., K963) will result in automatic rejection, as 'H' prefix codes are ineligible for these add-ons.
- Submitting H153 for weekday services is a common error; weekday assessments must be billed under the appropriate H103, H123, or H133 codes depending on the time of day.
- Failing to document the examination of multiple systems in the chart puts the claim at risk, as the code definition strictly requires a multi-system assessment.
Billing Tips
- Always append the 15% age premium for patients 65 and older to maximize the value of the H153 claim.
- Ensure the trauma premium E420 is added if the patient meets the specific ISS criteria, as this is one of the few eligible add-ons for H-prefix codes.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Assessment
Hospital and Institutional Consultations and Assessments
All insured services must be documented in appropriate records that establish that the service was provided, is the service submitted for payment, and was medically necessary, as per .
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