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Medical specialties
Internal Medicine OHIP billing codes
General internal medicine consultations and assessments, in-patient visits, MRP premiums, diabetes management and bedside diagnostics.
42 codes in 7 sections, fees from the current Schedule of Benefits. Every code the Schedule lists for specialty 13 is in the full Internal Medicine listing.
Consultations & assessments — office
- A135Consultation—
- A130Comprehensive internal medicine consultation—
- A435Limited ConsultationLimited Consultation - Internal Medicine—
- A136Repeat consultationRepeat consultation - Internal Medicine—
- A133Medical specific assessment—
- A134Medical specific re-assessment—
- A131Complex medical specific re-assessmentA complex medical specific re-assessment by an Internal Medicine (13) specialist for a patient with a complex, obscure, or serious condition. Requires a written report to the primary care physician and is limited to 4 per 12-month period.—
- A138Partial assessmentPartial assessment - Internal Medicine—
Hospital in-patient
- C135ConsultationConsultation - Internal Medicine (Hospital In-Patient)—
- C130Comprehensive internal medicine consultation—
- C435Limited consultationA limited consultation for a non-emergency hospital in-patient provided by a specialist in Internal Medicine or Occupational Medicine. This service is less demanding and requires substantially less time than a full consultation but must meet all other requirements for a consultation, including a written request from a referring practitioner.—
- C136Repeat consultationRepeat consultation - Internal Medicine - Hospital In-patient—
- C132Subsequent visit - first five weeksSubsequent visit - first five weeks (per visit)—
- C137Subsequent visit - sixth to thirteenth week inclusive—
- C139Subsequent visit - after thirteenth week—
- C138Concurrent care—
- C131Complex medical specific re-assessment—
- C134Medical specific re-assessment—
- C882Palliative careA palliative care visit rendered by the Most Responsible Physician (MRP) to a patient in a designated palliative care bed.$40.05
Diabetes management
- K045Diabetes management by a specialistA yearly management fee for specialists in Endocrinology, Internal Medicine, or Paediatrics providing ongoing care for a diabetic patient. Payment requires at least 4 preceding visits in the 12-month period and documentation of care consistent with Canadian Diabetes Association guidelines.—
- K046Diabetes team managementAnnual fee for a specialist in Internal Medicine (13) or Endocrinology (15) for comprehensive, team-based care of a patient with diabetes, which must include at least one Certified Diabetes Educator (CDE). See page <SectionPages>A95</SectionPages> for full requirements.—
Diagnostics
- G313Electrocardiogram - professional componentProvides payment for the professional component of a twelve-lead electrocardiogram (ECG), which requires a written interpretation. Payment is restricted for routine pre-operative screening and asymptomatic patients.$4.55
- G310Electrocardiogram - twelve lead - technical componentRepresents the technical component of a twelve-lead electrocardiogram (ECG). This service is not payable for routine pre-operative screening or for asymptomatic patients unless specific clinical indications or risk factors are present.$7.70
- G575Focused echocardiography - professional componentProvides for the professional component (interpretation and report) of a focused echocardiography study, which is an examination limited to a single component of the cardiac assessment. It is not to be claimed in conjunction with a pregnancy study.$13.95
- G650Professional component - 12 to 35 hours recordingProfessional component for the physician's interpretation and report of a Level 1 continuous ambulatory ECG (Holter monitor) recording lasting between 12 and 35 hours.$47.90
- G320Interpretation of telephone transmitted ECG rhythm strip - professional componentThe professional component service for the interpretation of a telephone-transmitted electrocardiography (ECG) rhythm strip.$4.30
- J303Extra pulmonary airways resistance by plethysmographyA diagnostic test that measures extrapulmonary airways resistance using plethysmography. This service has distinct technical (H) and professional (P) fee components which are billed separately.—
- J330Assessment of exercise induced asthmaA diagnostic test to assess for exercise-induced asthma, involving spirometry before and after a period of exercise sufficient to raise the heart rate to a target level.—
Bedside procedures
- Z332Aspiration for diagnosis or therapeutic drainagePerforms a therapeutic aspiration of the lung and pleura, also known as thoracentesis, to drain fluid, with or without taking a diagnostic sample. This is an Independent Operative Procedure (IOP).$104.40
- Z590Paracentesis - for diagnostic sampleA surgical procedure involving the aspiration of peritoneal fluid for diagnostic sampling. An additional fee (<billingCode>E542</billingCode>) is payable when performed outside of a hospital.$31.30
- Z591Paracentesis with therapeutic drainageA surgical procedure for the aspiration of fluid from the peritoneal cavity (paracentesis) primarily for therapeutic drainage, which may also include obtaining a diagnostic sample.$57.65
- G085Continuous venovenous haemofiltration - initial and acuteProvides for the initial and acute management of continuous venovenous haemofiltration (CVVH), a type of continuous renal replacement therapy. This code is limited to the first three services per episode of care.$385.75
Long-term care
- W235Consultation - Non-Emergency Long-Term Care In-Patient ServicesA consultation provided by a specialist in Internal or Occupational Medicine to a patient in a non-emergency long-term care setting, such as a chronic care hospital or nursing home, following a written request from a referring practitioner.—
- W236Repeat consultation - non-emergency long-term care in-patient servicesA repeat consultation requested by a referring practitioner for a patient in a long-term care setting, after the patient has received care from another physician following the initial consultation for the same problem. This service requires a new written referral.—
- W435Limited consultationA limited consultation for a patient in a non-emergency long-term care setting, rendered by a specialist in Internal Medicine. It requires a written referral and is a less time-intensive version of a full consultation.—
- W232Admission assessment - Type 1A Type 1 admission assessment for a patient in a non-emergency long-term care institution. This service is a general assessment rendered on admission by a specialist in Internal or Occupational Medicine.—
- W234Admission assessment - Type 2A Type 2 admission assessment occurs when the admitting physician makes an initial visit to assess the condition of the patient following admission and has previously rendered a consultation, general assessment or general re-assessment of the patient prior to admission.—
- W237Admission assessment - Type 3A general re-assessment for a patient being re-admitted to a long-term care institution after a minimum 3-day stay in another institution.—
- W239Periodic health visitA periodic health visit for patients in a long-term care institution, performed by an Internal Medicine or Occupational Medicine specialist. This service includes an age and gender-appropriate assessment for patients without an acute illness.—
How to use this internal med code set
This is a working list, not the whole Schedule. It carries the codes the Ontario Schedule of Benefits ties to internal medicine (specialty 13) — 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 internal med 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 internal medicine bill?
The consultations & assessments — office section of this set starts with A135 (Consultation). 8 codes are listed in that section.
What is in the Internal Medicine code set?
42 OHIP billing codes across 7 sections: Consultations & assessments — office; Hospital in-patient; MRP premiums; Diabetes management; Diagnostics; Bedside procedures; Long-term care. General internal medicine consultations and assessments, in-patient visits, MRP premiums, diabetes management and bedside diagnostics.
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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