U233 – Repeat E-Assessment
OHIP Other Code — Ophthalmology (23) · Schedule of Benefits
Repeat e-assessment is the first e-assessment performed by a particular specialist following an initial e-assessment or consultation by that specialist that is requested by the primary care physician or nurse practitioner for the same diagnosis where the specialist must review all relevant data provided by the primary care physician or nurse practitioner and provide an opinion that includes management advice to the primary care physician or nurse practitioner.
When to Use
- Use U233 when providing a follow-up opinion on a previously assessed diagnosis where the patient does not require an in-person visit.
- Select U233 instead of U231 when the patient has already had an initial e-assessment or consultation by you for the same clinical issue.
Common Pitfalls
- Submitting U233 without the referring physician or nurse practitioner's billing number will result in an automatic rejection.
- Billing U233 for a patient who has been seen in-person by you for the same condition within the last 12 months may trigger an audit for inappropriate service substitution.
Billing Tips
- Ensure your documentation explicitly references the initial consultation or e-assessment to justify the 'repeat' status and differentiate it from a new U231 request.
Effective: April 1, 2025
Consultations and Visits
Ophthalmology (23)
Assessment
Virtual Care Services, Assessments
An e-assessment is only eligible for payment if all of the following elements are included in the patient's permanent medical record of the specialist:
- patient's name and health number;
- name of the primary care physician or nurse practitioner;
- date of, and reason for, the request; and
- opinion, diagnosis, advice and/or recommendations of the specialist.
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