K091 – Post-operative monthly management of a bariatric surgery patient in a Bariatric RATC
OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Post-operative monthly management of a bariatric surgery patient is the supervision and medical management of a post-operative bariatric surgery patient registered with, and who is receiving post-operative care, in a BCoE or Bariatric RATC. The service is payable to the physician at the BCoE or Bariatric RATC who is most responsible for the post-operative supervision and medical management of the patient. In addition to the Common Elements in this Schedule, this service includes the provision of the following services to the same patient, during the post-operative period: a. All medication reviews. b. All telephone calls involving the staff, patient, patient’s relative(s) or patient’s representative and the physician in connection with the patient.
When to Use
- Use K091 once per calendar month to bill for the ongoing medical management and supervision of a patient enrolled in a Bariatric Center of Excellence (BCoE) or Regional Assessment and Treatment Centre (RATC).
- Use this code to capture all routine telephone calls and medication reviews performed for the patient during that month, as these are bundled into the K091 fee.
Common Pitfalls
- Submitting K091 more than once per month for the same patient will result in an automatic rejection, as the Ministry only pays the first claim received.
- Billing K091 in addition to other telephone management codes like K005 or K007 is prohibited, as these services are explicitly included in the K091 fee.
Billing Tips
- You may bill for separate consultations, assessments, or procedures (such as A007 or K030) on the same day as K091, provided they meet the requirements for those specific codes, as K091 is a management fee rather than a visit code.
Effective: April 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
ManagementFee
Hospital and Institutional Consultations and Assessments
Consultations, assessments and procedures rendered by the physician who is most responsible for the supervision and medical management of the post-operative bariatric surgery patient may be eligible for payment in addition to K091.
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