K034 – Not found
OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Telephone reporting of a specified reportable disease to a Medical Officer of Health (MOH) is the service of immediately providing all available information to a MOH in order to comply with the requirements of the Health Protection and Promotion Act and/or any applicable regulations, and includes providing, by any method, any subsequent information to a MOH regarding a previous report related to the same reported disease within the 12 month period.
When to Use
- Use K034 when you initiate an immediate telephone call to the local Public Health Unit to report a confirmed or suspected case of a disease listed in the Health Protection and Promotion Act, such as measles or invasive meningococcal disease.
- Use K034 for subsequent telephone communications to the Medical Officer of Health regarding additional clinical data or lab results for the same reportable disease within a 12-month window.
Common Pitfalls
- Billing K034 for routine electronic lab reporting or faxed notifications is a common audit trigger, as the code strictly requires a telephone conversation with the MOH or their delegate.
- Submitting K034 for diseases not explicitly listed in the Schedule of Benefits, such as non-reportable infections or common influenza, will result in automatic rejection.
- Attempting to bill K034 in addition to a standard office visit (e.g., A007) for the same patient encounter is often flagged as unbundling if the report is considered part of the visit's administrative requirements.
Billing Tips
- Ensure your chart note explicitly documents the name of the Public Health official or delegate you spoke with, the time of the call, and the specific reportable disease discussed to satisfy audit requirements for this service.
Effective: April 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Other
Diagnostic and Therapeutic Procedures
K034 is only eligible for payment if the patient record demonstrates that the required information of the report related to one of the specified reportable disease has been communicated immediately by telephone to the MOH.
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