K707 – Chronic pain 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, chronic pain out-patient case conference is participation by the physician most responsible for the treatment of the patient's chronic pain with at least 2 other participants that include physicians, regulated social workers and/or regulated health professionals regarding an out-patient.
When to Use
- Use K707 when coordinating a multi-disciplinary treatment plan for a patient with documented chronic pain lasting at least 6 months, involving at least two other regulated health professionals.
- Select K707 instead of K121 or K124 when the patient is an out-patient, as those codes are strictly reserved for in-patient or long-term care facility settings.
Common Pitfalls
- Billing K707 on the same day as a telephone consultation or another case conference code for the same patient will result in an automatic rejection.
- Failing to document the names and professional designations of the two required participants will lead to audit recovery, as the Ministry strictly enforces the 'at least 2 other participants' rule.
Billing Tips
- Ensure the clinical note explicitly states the patient's chronic pain duration exceeds 6 months to satisfy the specific eligibility criteria for this code.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Other
Assessments
In addition to standard medical record requirements, this service must meet the medical record requirements outlined in the Preamble for Case conferences.
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