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Medical specialties
Haematology OHIP billing codes
Haematology consultations, bone marrow procedures, transfusion and haemophilia support, infusions and laboratory interpretation.
31 codes in 5 sections, fees from the current Schedule of Benefits. Every code the Schedule lists for specialty 61 is in the full Haematology listing.
Consultations & assessments — office
- A615ConsultationHaematology Consultation—
- A655Limited ConsultationA limited consultation by a specialist in Haematology. This service is a less demanding consultation but follows the same general rules as a full consultation, including the need for a written referral from a physician, nurse practitioner or dental surgeon, and a report back to the referring practitioner.—
- A616Repeat Consultation—
- A613Medical Specific Assessment—
- A614Medical Specific Re-AssessmentMedical Specific Re-assessment (Haematology)—
- A618Partial AssessmentPartial Assessment - Haematology—
Hospital in-patient
- C615ConsultationA consultation for a non-emergency hospital in-patient rendered by a Haematology specialist following a written request from a referring practitioner.—
- C655Limited ConsultationA limited consultation is a consultation for a non-emergency hospital in-patient which is less demanding and requires substantially less time than a full consultation. It is performed by a specialist in Haematology (61).—
- C616Repeat ConsultationA repeat consultation rendered by a specialist in Haematology (61) to a non-emergency hospital in-patient. This is an additional consultation for the same problem, following care by another physician since the initial consultation.—
- C613Medical Specific AssessmentA medical specific assessment rendered by a Haematologist (specialty 61) for a non-emergency hospital in-patient, requiring a detailed history and examination of the affected regions or systems.—
- C614Medical Specific Re-AssessmentA medical specific re-assessment performed by a haematologist for a non-emergency hospital in-patient, requiring a follow-up history and examination of one or more body systems.—
- C611Complex medical specific re-assessmentA complex medical specific re-assessment for a hospital in-patient, rendered by a Haematologist due to a condition's complexity, obscurity, or seriousness. This service has specific annual limits and requires a written report to the patient's primary care physician.—
- C612Subsequent Visits, First Five Weeks per VisitA routine assessment by a Haematologist for a non-emergency hospital in-patient during the first five weeks of admission, limited to one visit per day.—
- C617Haematology - Subsequent Visit, Sixth to Thirteenth WeekA subsequent visit by a Haematologist to a non-emergency hospital in-patient, rendered during the sixth to the thirteenth week of admission. This service is limited to a maximum of three visits per patient per week.—
- C619Subsequent Visit - After Thirteenth WeekSubsequent visit - after thirteenth week (maximum 6 per patient per month) (per visit)—
- C618Concurrent CareA routine assessment rendered in-hospital by a consultant for a patient whose care is primarily managed by another physician (the MRP), following a request from the MRP for continued directive care. See <SectionPages>GP48</SectionPages> for details.—
Procedures & infusions
- Z403Bone marrow aspiration and/or core biopsyA procedure for bone marrow aspiration and/or core biopsy. Payment is contingent on obtaining a usable sample of material for examination.$133.55
- G098Transfusion supportA weekly management fee payable to a specialist for providing non-emergency transfusion support, iron overload management, and care for Sickle Cell Disease, Thalassemia, or transfusion-dependent Congenital Hemolytic Anemia in an outpatient setting.$32.35
- G100Haemophilia infusionA weekly management fee for a specialist providing non-emergency care for a patient on home/self-care haemophilia infusion therapy, covering routine visits, supervision, and communication.$32.35
- G381Standard chemotherapyStandard chemotherapy service for malignant or autoimmune diseases using agents with minor toxicity. This service includes physician supervision, the infusion itself, and all patient assessments for a 24-hour period post-treatment.$54.50
- G390Supervision of chemotherapy, biologic agent, or bispecific antibody infusionSupervision of chemotherapy for induction phase of acute leukemia or myeloablative therapy prior to bone marrow transplantation (maximum of 1 per induction phase or myeloablative therapy); and/or supervision of biologic agent(s) such as Chimeric Antigen Receptor T-Cell Therapy (CAR-T) infusion (maximum of 1 per infusion); and/or supervision of bispecific antibody infusion, during initial dosing phase, where there is a high risk of cytokine release syndrome (maximum of 3 per initial dosing phase)$262.40
- Z425Bone marrow transplantation - aspiration from donorSurgical aspiration of bone marrow from a donor, performed as part of a team fee for bone marrow transplantation. This service is only insured for specific qualifying diagnoses, which require verification with Cancer Care Ontario’s Guidelines.$506.75
- Z426Bone marrow transplantation - infusion into recipientSurgical infusion of donor bone marrow into a recipient. This is a team-fee service that requires consultation with the Ministry of Health to confirm qualifying diagnoses before it is considered an insured benefit.$62.55
Laboratory interpretation
- L800Blood film interpretation (Romanowsky stain)A laboratory medicine procedure for the professional interpretation of a blood film prepared with a Romanowsky stain.$29.40
- L802Bone marrow interpretation (Romanowsky stain)A laboratory service for the professional interpretation of a bone marrow specimen that has been prepared with a Romanowsky stain.$64.45
- L826Blood film interpretation (special stain)Payable for the professional interpretation of a blood film prepared with a special stain.$16.05
- L829Haemoglobinopathy interpretationHaemoglobinopathy interpretation service. This service is only eligible for payment when test results are abnormal.$25.70
How to use this haematology code set
This is a working list, not the whole Schedule. It carries the codes the Ontario Schedule of Benefits ties to haematology (specialty 61) — its own consultation and assessment codes, in-patient visits, premiums and the diagnostics or procedures that make up most of a day — sectioned the way a shift sheet reads. Codes open to every specialty that a haematology physician also bills (general assessments, forms, special visit premiums) live in the Family Practice and Special visit premiums sets.
Each code links to its full Schedule entry: fee history, restrictions, required diagnoses and the codes it can or cannot be billed with. Fees shown are the current provider or specialist fee; percentage premiums show the percentage they add to the base service.
Common questions
Which consultation or assessment code does haematology bill?
The consultations & assessments — office section of this set starts with A615 (Consultation). 6 codes are listed in that section.
What is in the Haematology code set?
31 OHIP billing codes across 5 sections: Consultations & assessments — office; Hospital in-patient; Premiums; Procedures & infusions; Laboratory interpretation. Haematology consultations, bone marrow procedures, transfusion and haemophilia support, infusions and laboratory interpretation.
Are these the current OHIP fees?
Fees are read from the current Ontario Schedule of Benefits for Physician Services and refreshed hourly. Claims are paid at the fee in force on the service date, so always confirm the effective date on the code page.
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