K181 – Consultation and Management for Acute Cerebral Vascular Syndrome (ACVS) - after first 30 minutes, must include intravenous thrombolysis therapy and monitoring, per 30 minute unit (or major part thereof)
OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits
K181 is described as 'after first 30 minutes, must include intravenous thrombolysis therapy and monitoring, per 30 minute unit (or major part thereof)'. It is a Consultation and Management service for Acute Cerebral Vascular Syndrome (ACVS). It is only eligible for payment for patients seen within the timeframe for eligibility for intravenous thrombolysis therapy as defined by the Canadian Stroke Best Practices, and for patients treated with intravenous thrombolysis therapy. The service must be rendered in a hospital with CT or MRI facilities onsite by a specialist in Neurology (18), and the physician must remain in constant attendance with the patient. G521, G522, G523, or G391 are not eligible for payment with K181. K181 is limited to a maximum of 6 units per patient per day.
When to Use
- Use K181 to bill for the time spent in constant attendance beyond the initial 30 minutes covered by A384 during the acute phase of intravenous thrombolysis administration.
- Apply this code specifically when managing a patient who meets the Canadian Stroke Best Practices criteria for thrombolysis and requires continuous monitoring by a neurologist during the infusion period.
Common Pitfalls
- Billing K181 alongside G521, G522, G523, or G391 will result in an automatic rejection, as these codes are mutually exclusive for the same patient on the same day.
- Failure to document exact start and stop times for the service, as well as the patient's symptom onset time, is a primary cause for audit recovery.
- Exceeding the maximum limit of 6 units per patient per day will trigger a rejection for the excess units.
Billing Tips
- Ensure the total time billed across A384 and K181 reflects only the period of constant attendance; do not include time spent on unrelated administrative tasks or non-thrombolysis related care.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Consultation
Psychotherapy, Psychiatric and Counselling Services
Consultation and Management for ACVS is only eligible for payment if start and stop times of the services and the time of onset of symptoms are recorded in the patient's permanent medical record.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.