All codes
K739
K739 – Physician to physician e-consultation – Consultant physician
OHIP Consultations and Visits Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Physician/nurse practitioner to physician e-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") who is competent to give advice in the particular field because of the complexity, seriousness, or obscurity of the case and where both the request and opinion are sent by electronic means through a secure server. This service is only eligible for payment if the consultant physician has provided an opinion and/or recommendations for patient treatment and/or management within thirty (30) days from the date of the e-consultation request. For the purpose of this service, “relevant data” includes family/patient history, history of the presenting complaint, laboratory and diagnostic tests, where indicated. The consultant physician service includes all services rendered by the consultant physician to provide opinion/advice/recommendations on patient care, treatment and management to the referring physician or nurse practitioner. The consultant physician is required to review all relevant data provided by the referring physician or nurse practitioner. Where a service is requested by a nurse practitioner, the consultant physician shall provide the report to the nurse practitioner and the patient's primary care provider, if applicable.
Referral requiredFrom: Physician, NursePractitioner
The consultant physician must include the referring physician's or nurse practitioner's provider number with the claim.
An e-consultation is only eligible for payment if all of the following elements are included in the patient's permanent medical record of the consultant physician: 1. patient's name and health number; 2. name of the referring physician or nurse practitioner; 3. date of, and reason for, the request; and 4. opinion, diagnosis, advice and/or recommendations of the consultant physician.
The Definition/Required elements of service and payment rules for consultations in the General Preamble are not applicable to physician/nurse practitioner to physician e-consultations.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.