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P038

P038Attendance at labour - patient transferred to another centre for delivery

OHIP Plastic Surgery Code — OBSTETRICS · Schedule of Benefits

Payable to a physician for attendance at labour when the patient is transferred to another centre for delivery. This service compensates the physician for their time and care provided before the transfer. This code is used in lieu of a delivery code (e.g., P006, P018) by the physician managing labour prior to the patient's transfer.

When to Use

  • Use P038 when you have actively managed a patient in labour but the patient is transferred to a higher-level facility for delivery due to complications or resource requirements.
  • Use this code when the delivery does not occur under your care, effectively replacing the standard delivery codes like P006 or P018.

Common Pitfalls

  • Billing P038 in conjunction with a delivery code (e.g., P006, P018, or P020) will result in an automatic rejection as they are mutually exclusive.
  • Failing to document the specific clinical rationale for the transfer in the medical record is a primary audit risk for this code.

Billing Tips

  • Ensure you append the appropriate after-hours premiums (E409 or E410) if the labour attendance and transfer coordination occur during the specified time windows to maximize the claim value.
Provider Fee$211.20

Effective: April 1, 2025

Category

K. Obstetrics

Subcategory

OBSTETRICS

Service Type

Procedure

Code Classes

Obstetrics

Medical record must document the physician's attendance at labour and the details of the patient's subsequent transfer to another centre for delivery, establishing the medical necessity for the service as billed.

As per , the medical record must establish that an insured service was provided, the service for which the account is submitted is the service that was rendered, and the service was medically necessary.

Sex Restriction

Female

when patient transferred to another centre for delivery

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