K703 – Geriatric out-patient case conference
OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits
In addition to the definitions, required elements, payment rules, medical record requirements in the Preamble - Case conferences, geriatric 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 and/or regulated health professionals regarding an out-patient who is at least 65 years of age or, a patient less than 65 years of age who has dementia.
When to Use
- Use K703 when coordinating care for a community-dwelling patient aged 65+ with at least two other regulated health professionals, such as a pharmacist and a home care coordinator.
- Use K703 for patients under 65 with a documented dementia diagnosis when a multidisciplinary team meeting is required to manage complex outpatient care plans.
Common Pitfalls
- Billing K703 on the same day as a K121 or K124 will trigger an automatic rejection, as these codes are mutually exclusive for the same patient.
- Attempting to bill K703 for an inpatient in an acute care or long-term care facility is a common audit error; use K121 or K124 respectively for those settings.
- Failure to document the names and professional designations of the two required participants will lead to clawbacks during a Ministry audit.
Billing Tips
- Ensure the total time spent is documented, as K703 is intended for conferences that require significant multidisciplinary input beyond standard office visits.
- Verify that your participants are 'regulated' health professionals, as non-regulated support staff or family members do not count toward the two-participant requirement.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Other
Interviews
Must meet the medical record requirements for Case conferences as defined in the Schedule Preamble.
[65, null, "years", "Patient is at least 65 years of age", true] OR [null, 65, "years", "Patient is less than 65 years of age and has dementia", false]
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