K733 – CritiCall telephone consultation - Consultant physician
OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A telephone consultation arranged by CritiCall Ontario where a referring physician or nurse practitioner, based on their professional knowledge of a patient, requests the opinion of a consultant physician. This service includes all activities rendered by the consultant physician necessary to provide advice on patient management, including the review of all relevant data provided by the referring physician/nurse practitioner. This service is an exception to the standard consultation rules outlined in the General Preamble.
When to Use
- Use K733 when you are a consultant physician providing telephone advice to a referring provider via CritiCall for a patient who is not currently in an emergency department or urgent care setting.
- Use K733 when you are providing a specialist opinion for a patient transfer or management plan facilitated by CritiCall, provided you are not the physician on duty in the ED or urgent care clinic.
Common Pitfalls
- Claiming K733 while on duty in an emergency department or hospital urgent care clinic will lead to rejections; you must use K737 in these settings.
- Attempting to bill K733 for standard telephone consultations not facilitated by CritiCall is an audit risk; K733 is strictly reserved for CritiCall-arranged services.
- Failing to link E150 when performing complex neurosurgical imaging reviews during a K733 consultation results in missed revenue.
Billing Tips
- Always ensure the CritiCall reference number is available in your records, as this is the primary audit trail for the validity of the K733 claim.
- If you are a neurosurgeon, verify if the case qualifies for the E150 add-on to increase the total claim value beyond the base K733 fee.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Consultation
Consultations
The Definition/Required elements of service and Payment rules for consultations in the General Preamble are not applicable to CritiCall telephone consultations.
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