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K701
K701 – Mental health out-patient case conference
OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A mental health out-patient case conference is participation by the physician most responsible for the care of the patient with at least 2 other participants that include physicians, regulated social workers, regulated health professionals, and/or personnel employed by a mental health community agency funded by the Ontario Ministry of Health, regarding an adult out-patient. This service is subject to the definitions, required elements, payment rules, and medical record requirements for case conferences outlined in the Schedule of Benefits Preamble.
When to Use
- Use K701 when coordinating care for an adult patient with at least two external professionals, such as a social worker and a community mental health agency worker, to discuss a complex treatment plan.
- Use K701 when participating in a formal case conference for an adult patient that does not meet the criteria for K121 because the patient is an out-patient rather than an in-patient.
Common Pitfalls
- Billing K701 for a discussion involving only one other participant; the Schedule of Benefits strictly requires at least two other participants.
- Attempting to bill K701 on the same day as a K121 or other telephone consultation codes, which will result in an automatic rejection.
- Using K701 for patients under 18 years of age, which is a common error; K704 must be used for pediatric mental health case conferences.
Billing Tips
- Ensure your documentation explicitly lists the names and professional designations of the two required participants to survive a potential audit.
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