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Medical specialties
Infectious Diseases OHIP billing codes
Infectious disease consultations and assessments across office, hospital and long-term care.
31 codes in 4 sections, fees from the current Schedule of Benefits. Every code the Schedule lists for specialty 46 is in the full Infectious Disease listing.
Consultations & assessments — office
- A465Infectious Disease Consultation—
- A460Comprehensive Infectious Disease Consultation—
- A275Limited consultation - Infectious Disease—
- A466Infectious Disease Repeat Consultation—
- A463Medical specific assessment - Infectious Disease—
- A464Infectious Disease - Medical specific re-assessment—
- A461Complex medical specific re-assessmentComplex medical specific re-assessment - Infectious Disease—
- A468Partial assessment - infectious disease—
Hospital in-patient
- C465Infectious Disease Consultation - Non-Emergency Hospital In-PatientA consultation service rendered by a specialist in Infectious Disease to a non-emergency hospital in-patient.—
- C460Comprehensive infectious disease consultation - non-emergency hospital in-patientA comprehensive infectious disease consultation for a non-emergency hospital in-patient, rendered by a specialist in infectious disease. This service requires a minimum of 75 minutes of direct patient contact and must meet all standard consultation requirements.—
- C275Limited consultation - infectious disease - non-emergency hospital in-patientA limited consultation rendered by an Infectious Disease specialist (46) for a non-emergency hospital in-patient. This service requires a written request from a referring practitioner.—
- C466Repeat consultation - infectious disease, non-emergency hospital in-patientA repeat consultation for a non-emergency hospital in-patient provided by an Infectious Disease specialist. This is an additional consultation for the same presenting problem, rendered after another physician has provided care following the initial consultation.—
- C463Infectious disease medical specific assessment - non-emergency hospital in-patientA medical specific assessment rendered by an Infectious Disease specialist to a non-emergency hospital in-patient.—
- C464Medical specific re-assessmentA medical specific re-assessment for a non-emergency hospital in-patient, rendered by an Infectious Disease specialist.—
- C461Complex medical specific re-assessmentA complex medical specific re-assessment for a hospital in-patient, performed by a specialist in Infectious Disease (46). This service is for a patient with a complex, obscure, or serious condition and requires a written report to the patient's primary care physician.—
- C462Subsequent visit - hospital inpatient, or resident in a long-term care facility, or patient receiving home care, or patient in a correctional facility - by an infectious disease specialistSubsequent visit by a specialist in Infectious Disease for an acute care hospital in-patient during the first five weeks of admission. Limited to one per day.—
- C467Subsequent Visit - Sixth to Thirteenth Week InclusiveA routine subsequent visit by an Infectious Disease specialist for a hospital in-patient, rendered between the sixth and thirteenth week of admission. This service is limited to a maximum of three visits per patient per week.—
- C468Subsequent visits per monthA routine assessment in a hospital by a consultant when the family physician remains the most responsible physician but requests continued directive care from the consultant.—
- C469Subsequent visit - infectious disease physician - long-term care institutionA subsequent visit for a hospital in-patient by an Infectious Disease specialist, applicable for care after the thirteenth week of admission, limited to six per patient per month.—
Long-term care
- W465ConsultationA consultation service by an Infectious Disease specialist for a patient in a non-emergency long-term care institution. This service requires a written request and is subject to frequency limits as outlined on page <SectionPages>GP17</SectionPages>.—
- W466Repeat ConsultationA repeat consultation for the same presenting problem, rendered in a non-emergency long-term care institution setting. Requires a new referral from a practitioner after care was rendered by another physician in the interim.—
- W275Limited ConsultationA limited consultation for a non-emergency in-patient in a long-term care institution. This service is a consultation which is less demanding and requires substantially less time than a full consultation.—
- W463Infectious Disease Consultation - Nursing Home/Home for the Aged - First 2 Subsequent Visitsfirst 2 subsequent visits per patient per month—
- W460Subsequent visit by a specialist in infectious diseaseComprehensive infectious disease consultation - subject to the same conditions as A460—
- W464Subsequent visit - Infectious DiseaseA general re-assessment of a patient in a nursing home, as required by the *Nursing Homes Act*. This service is for patients in long-term care settings and is subject to usage limits.—
- W292Type 1 - Admission AssessmentA Type 1 admission assessment, defined as a general assessment rendered to a patient upon admission to a non-emergency long-term care institution.—
- W297Admission Assessment - Type 3A Type 3 admission assessment is a general re-assessment of a patient who is re-admitted to a long-term care institution after a minimum 3 day stay in another institution.—
How to use this id code set
This is a working list, not the whole Schedule. It carries the codes the Ontario Schedule of Benefits ties to infectious disease (specialty 46) — 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 id 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 infectious diseases bill?
The consultations & assessments — office section of this set starts with A465 (Infectious Disease Consultation). 8 codes are listed in that section.
What is in the Infectious Diseases code set?
31 OHIP billing codes across 4 sections: Consultations & assessments — office; Hospital in-patient; Premiums; Long-term care. Infectious disease consultations and assessments across office, hospital and long-term care.
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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