U236 – Follow-Up E-Assessment
OHIP Other Code — Ophthalmology (23) · Schedule of Benefits
A follow-up e-assessment is the limited e-assessment rendered for follow-up by the specialist who has previously rendered any insured service to the patient for the same diagnosis. The specialist must review all relevant information submitted and provide an opinion and/or management advice to the primary care physician or nurse practitioner.
When to Use
- Use U236 when providing a follow-up opinion on a patient you have previously assessed, specifically when the primary care provider requests a review of new test results or clinical updates without a physical examination.
- Select U236 instead of a standard follow-up visit code when the interaction is strictly electronic or telephonic and does not meet the requirements for a full consultation or major assessment.
Common Pitfalls
- Claims will be rejected if the referring physician or nurse practitioner's billing number is omitted from the claim submission.
- Billing U236 for a patient you have not previously seen or for a new diagnosis is an audit risk; use U235 for initial e-assessments instead.
- Attempting to bill U236 in conjunction with a physical visit on the same day for the same patient will trigger a rejection due to service duplication.
Billing Tips
- Ensure your documentation explicitly references the primary care provider's request and your specific management advice to satisfy the mandatory documentation requirements for this code.
Effective: April 1, 2025
Consultations and Visits
Ophthalmology (23)
Assessment
Virtual Care Services, Assessments
patient's name and health number
name of the primary care physician or nurse practitioner
date of, and reason for, the request
opinion, diagnosis, advice and/or recommendations of the specialist
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