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K021
K021 – Sexual Assault Examination - Male
OHIP Consultation & Visit Premium Codes Code — Family Practice & Practice in General (00) · Schedule of Benefits
This service is for the investigation of an alleged sexual assault on a male patient. It includes the required documentation using the evidence kit provided by the Ministries of the Attorney General and the Solicitor General.
When to Use
- Use K021 when performing a comprehensive forensic examination on a male patient following an alleged sexual assault, specifically utilizing the provincial evidence kit.
- Bill K021 instead of a standard A007 or A001 assessment when the clinical encounter is dedicated to the forensic evidence collection process.
Common Pitfalls
- Billing K021 for a general follow-up or counseling session related to sexual assault that does not involve the formal evidence kit documentation.
- Attempting to bill a concurrent A-code assessment on the same day as K021, which will result in a rejection for duplicate assessment services.
- Failing to include the required forensic documentation, which makes the claim ineligible for the K021 fee if audited.
Billing Tips
- Always append the appropriate Special Visit Premium (Table I-VIII) to K021 if the examination occurs outside of standard office hours or in an emergency setting.
- Ensure the patient's sex is recorded as male in the claim submission to avoid automatic rejection against the K021 gender restriction.
Provider Fee$282.75
Effective: April 1, 2026
Category
Consultations and Visits
Subcategory
Family Practice & Practice in General (00)
Service Type
Assessment
Code Classes
Assessments
Documentation must be completed using the evidence kit provided by the Ministries of the Attorney General and the Solicitor General.
Sex Restriction
Male
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