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K731
K731 – Physician to physician telephone consultation - Consultant physician
OHIP Consultations and Visits Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Physician to physician telephone consultation is a service where the referring physician or nurse practitioner, in light of his/her professional knowledge of the patient, requests the opinion of a physician (the “consultant physician") by telephone who is competent to give advice in the particular field because of the complexity, seriousness, or obscurity of the case.
This service is only eligible for payment if the consultant physician has provided an opinion and/or recommendations for patient treatment and/or management.
For the purpose of this service, “relevant data” include family/patient history, history of the presenting complaint, laboratory and diagnostic tests, where indicated and feasible in the circumstances.
Definition/Required elements of service – Consultant physician
This service includes all services rendered by the consultant physician to provide opinion/advice/recommendations on patient care, treatment and management to the referring physician. The consultant physician is required to review all relevant data provided by the referring physician or nurse practitioner.
Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon
All insured services must be documented in appropriate records, establishing that an insured service was provided, the service claimed is the service rendered, and the service was medically necessary, as per .
Keeping and maintaining appropriate medical records is a common element of all insured services, as per .
The Definition/Required elements of service and payment rules for consultations in the General Preamble are not applicable to physician to physician telephone consultations.
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