K027 – Certification of Medical Eligibility for Ohcap - Form Only
OHIP Consultation & Visit Premium Codes Code — Family Practice & Practice in General (00) · Schedule of Benefits
Certification of Medical Eligibility for the Ontario Hepatitis C Assistance Program (OHCAP). This service includes only the completion of the Application for OHCAP - Physician's Form and is only payable when provided without an associated consultation or visit on the same day. If any other consultation or visit is rendered on the same day, the completion of the form is considered a component of that other service and is not separately payable.
When to Use
- Use K027 when the patient presents solely for the completion of the OHCAP Physician's Form without any other clinical assessment or counseling occurring during the same encounter.
- Use this code when you are acting as the certifying physician for a patient's OHCAP application and no other billable service is rendered on that date.
Common Pitfalls
- Billing K027 on the same day as an office visit (e.g., A007) will result in an automatic rejection or a clawback, as the form completion is considered bundled into the visit fee.
- Attempting to bill K027 in conjunction with K026 is prohibited, as both codes represent administrative form completion services that are mutually exclusive.
Billing Tips
- Ensure the patient encounter is strictly limited to the administrative task of form completion to justify the standalone billing of K027.
Effective: April 1, 2025
Consultations and Visits
Family Practice & Practice in General (00)
Other
Assessments
Completion of the Application for OHCAP - Physician's Form.
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