All codes
K187
K187 – Acute post-discharge community psychiatric care premium
OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits
When to Use
- Use K187 as an add-on to K195, K196, K197, or K198 for a follow-up visit within 28 days of a psychiatric inpatient discharge.
- Apply this premium when providing community-based psychiatric management for a patient recently transitioned from an acute psychiatric facility.
Common Pitfalls
- Billing K187 for services occurring beyond the 28-day window post-discharge will result in automatic rejection.
- Attempting to claim K187 with a standard office visit code (e.g., A005) instead of the mandatory K195-K198 series will lead to claim denial.
- Failing to verify the exact discharge date from the hospital record often leads to audit discrepancies regarding the four-week eligibility period.
Billing Tips
- Ensure the claim includes both the base psychiatric management code (K195-K198) and the K187 premium on the same submission to trigger the percentage increase.
- You may concurrently bill K188 if the visit meets the criteria for both the acute post-discharge premium and the specific psychiatric management requirements.
Percentage Premium: 0.15%
This code applies a percentage increase to the base procedure fee
Provider Fee$0.00
Specialist Fee$0.01
Effective: September 1, 2011
Category
A. Consultations and Visits
Subcategory
CONSULTATIONS AND VISITS
Service Type
PercentageIncrease
Code Classes
Other Premiums (including After Hours Procedure Premiums)
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