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New Virtual Care Codes - FAQ

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I can’t find the new codes in the mobile app?

Answer: You will need to update the mobile app as follows:

Please navigate to the left menu -> Preferences -> Refresh App Data -> Update. You should then be able to see the codes when creating a new claim.

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Which code should I bill?

Answer: For details of the rules regarding billing the new codes, please refer to the OHIP Bulletin 4745, OHIP Bulletin 4747 and the OMA website. Alternatively, you can contact the MoH (1-800-262-6524) for advice.

 

I billed these new codes but they got rejected. Why is that?

Answer: According to the OHIP Bulletin 4745:

Please Note: While payment for the provision of services associated with these temporary codes is effectively March 14, 2020, system changes will be implemented over the coming weeks to process payment. As a result, the Ministry requests that physicians wait to submit claims for these codes until further notice. Further information regarding each of these changes will be forthcoming.

You can keep them in the "Rejected" status and resubmit them as soon as the changes are implemented in the MoH system. 

 

How to bill K083? 

Answer: According to the OHIP Bulletin #4745, the quantity for K083 = listed fee of the services provided in the SoB, rounded to the nearest $5, divided by 5.

The below table provides an example (for Internal Medicine specialty):

Code

Description

Fee

K083 Units

K083 Fee

A135

Consultation

$157.00

31.00

$155.00

A435

Limited consultation

$105.25

21.00

$105.00

A136

Repeat consultation

$105.25

21.00

$105.00

A133

Medical specific assessment

$79.85

16.00

$80.00

A134

Medical specific re-assessment

$61.25

12.00

$60.00

A131

Complex medical specific re-assessment

$70.90

14.00

$70.00

A138

Partial assessment

$38.05

8.00

$40.00

 

How do I bill H409 / H410 without patient info?

Answer: Please note the ministry currently requests that physicians wait to submit claims for these codes until further notice. Please continue to check the MoH bulletins and OMA website for further updates and information.

For details of the rules regarding billing the new codes, please refer to the OHIP Bulletin 4745, OHIP Bulletin 4747 and the OMA website. Alternatively, you can contact the MoH (1-800-262-6524) for advice.

If you wish to enter these codes without patient information in our system, you are able to create a dummy patient for codes that are not patient specific.

  1. Create a dummy patient with the health card value of 9777777779
  2. Create a new claim with this patient
  3. When the claim is ready to be submitted to the Ministry, we will exclude the patient details entered.

 

 

When can we submit these codes?

Answer: The MoH system changes will be implemented over the coming weeks to process payments for new codes. In the meantime, you can enter these codes in our software and save them. Keep them in "Saved" status until further notice by the MoH to submit them.

 

I provided Telemedicine services via OTN. How do I add 'Service Location Indicator' to the claim?

Answer: Please follow these instructions: How to Select The Service Location Indicator (SLI).

For more information about billing for services via OTN, please see OHIP Billing Information for Telemedicine Services

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