K734 – Physician to physician telephone consultation - Referring physician
OHIP Consultation & Visit Premium Codes 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 for the referring physician who is on duty in an emergency department or a hospital urgent care clinic. Definition/Required elements of service – Referring physician The referring physician or nurse practitioner initiates the telephone consultation with the intention of continuing the care, treatment and management of the patient. In addition to the Constituent and Common Elements of Insured Services described in the General Preamble of this Schedule, this service includes the transmission of relevant data to the consultant physician and all other services rendered by the referring physician or nurse practitioner to obtain the advice of the consultant physician. 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.
When to Use
- Use K734 when you are an emergency department or urgent care physician seeking specialized advice on a complex case to manage the patient yourself, rather than transferring care.
- Use this code when you need to discuss a patient's management plan with a specialist while the patient remains under your care in the emergency department.
Common Pitfalls
- Billing K734 when you are not working in an emergency department or hospital urgent care clinic, as this is a strict eligibility requirement.
- Attempting to bill K734 when the outcome of the call is a formal transfer of care or a referral for a face-to-face consultation, which would instead fall under standard consultation rules.
- Failing to document the name and billing number of the consultant physician, which is required to substantiate the claim during an audit.
Billing Tips
- You may bill K734 in addition to an emergency department visit code (e.g., K002 or A405) for the same patient on the same day, provided the telephone consultation is a distinct service.
- Ensure your documentation clearly identifies the consultant physician and the specific clinical advice requested to distinguish this from a routine administrative hand-off.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Other
Consultations
This service is eligible for payment in addition to visits or other services provided to the same patient on the same day by the same referring physician.
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