K737 – CritiCall telephone consultation - Consultant physician
OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits
CritiCall telephone consultation is a service where a referring physician or nurse practitioner requests the opinion of a consultant physician by telephone, and the consultation has been arranged by CritiCall Ontario. The service rendered by the consultant physician, using code K737, includes all services necessary to provide advice on patient management, including reviewing all relevant data. This code is specifically used when the consultant physician is on duty in an emergency department or a hospital urgent care clinic.
When to Use
- Use K737 when you are the consultant physician on duty in an emergency department or urgent care clinic and receive a request for advice facilitated through CritiCall Ontario.
- Use this code for telephone management advice when the patient is in another facility and the interaction is formally coordinated by the CritiCall system.
Common Pitfalls
- Billing K733 instead of K737 when you are physically on duty in an emergency department or hospital urgent care clinic.
- Submitting a claim without verifying that the consultation was officially arranged by CritiCall Ontario, as this is a mandatory requirement for payment.
- Attempting to bill a standard consultation code (e.g., A007) for a service that was initiated and managed through the CritiCall telephone protocol.
Billing Tips
- If you perform a complex neurosurgical imaging review during the call, ensure you append E150 to your K737 claim to capture the additional fee.
- Always confirm the CritiCall reference number provided during the call, as this is essential for audit trails and verifying the service was correctly arranged.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Assessment
Assessments, Virtual Care Services
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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