All codes
Y861
Y861 – Y861
OHIP Other Code · Schedule of Benefits
When to Use
- Use Y861 as a diagnostic code to indicate a patient's status as a 'carrier' of a communicable disease, such as a positive COVID-19 or MRSA screening result, when no active treatment is being provided.
- Apply this code when documenting a patient who is asymptomatic but requires isolation or monitoring due to a known exposure or carrier state.
Common Pitfalls
- Do not use Y861 as a primary diagnosis for an active, symptomatic infection, as this will lead to claims being rejected for lack of medical necessity for the service provided.
- Avoid using this code for routine screening purposes where a more specific 'Z' code or screening-specific diagnostic code is required by the Schedule of Benefits.
Billing Tips
- Always pair Y861 with the appropriate service code for the encounter, ensuring the clinical note explicitly justifies why the patient is classified as a carrier rather than an active case.
Provider Fee$0.00
Surgical Assistant Fee$130.30
Non-Anaesthetist Fee$81.12
Effective: April 1, 2026
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