TABLE OF CONTENTS. GP. General Preamble
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1 GP. General Preamble TABLE OF CONTENTS Introduction... GP1 Definitions... GP2 General Information... GP6 Constituent and Common Elements of Insured Services... GP9 Specific Elements of Assessments... GP11 Consultations... GP12 Assessments... GP14 Hospital and Institutional Consultations and Assessments... GP26 Psychotherapy, Psychiatric and Counselling Services... GP37 Interviews... GP41 Delegated Procedure... GP42 Age-Based Fee Premiums... GP43 Special Visit Premiums... GP44 Team Care in Teaching Units... GP53 Surgical Assistants Services... GP54 Anaesthesiologists Services... GP58 Supportive Care/Monitoring By Surgical Assistant or Anaesthesiologist... GP64 Other Premiums... GP65 Emergency Department Sessional Fees... GP69 Emergency Department Alternative Funding Agreements... GP71 A. Consultations and Visits Family Practice & Practice in General (00)... A1 Anaesthesia (01)... A45 Cardiology (60)... A47 Cardiac Surgery (09)... A49 Clinical Immunology (62)... A50 Community Medicine (05)... A51 Dermatology (02)... A53 Emergency Medicine (12)... A56 Endocrinology & Metabolism (15)... A57 Gastroenterology (41)... A62 General Surgery (03)... A64 General Thoracic Surgery (64)... A66 Genetics (22)... A67 Geriatrics (07)... A71 Haematology (61)... A75 Infectious Disease (46)... A76 Internal and Occupational Medicine (13)... A78 Laboratory Medicine (28)... A81 Medical Oncology (44)... A82 Nephrology (16)... A84 Neurology (18)... A86 Neurosurgery (04)... A89 Nuclear Medicine (63)... A90 Obstetrics and Gynaecology (20)... A91 Ophthalmology (23)... A92 Orthopaedic Surgery (06)... A97 Otolaryngology (24)... A99 Paediatrics (26)... A100 Physical Medicine & Rehabilitation (31)... A105 Plastic Surgery (08)... A110 Psychiatry (19)... A111 Diagnostic Radiology (33)... A117 i
2 Radiation Oncology (34)... A119 Respiratory Disease (47)... A120 Rheumatology (48)... A122 Urology (35)... A126 Vascular Surgery (17)... A127 B. Nuclear Medicine - IN VIVO Preamble... B1 Cardiovascular System... B3 Endocrine System... B4 Gastrointestinal System... B5 Genitourinary System... B6 Haematopoietic System... B7 Musculoskeletal System... B8 Nervous System and Respiratory System... B9 Miscellaneous... B10 Scintimammography... B11 Clinical Procedures Associated With Diagnostic Nuclear Medicine... B12 B. Positron Emission Tomography (PET) Preamble... B14... B17 C. Radiation Oncology Preamble... C1 Radiotherapy... C2 Radium and Radioisotopes (Sealed Sources)... C5 Radioisotopes (Non-sealed Sources)... C6 D. Diagnostic Radiology Preamble... D1 Head and Neck... D4 Spine and Pelvis... D5 Upper Extremities... D6 Lower Extremities... D7 Skeletal Surveys... D8 Chest and Abdomen... D9 Gastrointestinal Tract... D10 Genitourinary Tract... D11 Obstetrics and Gynaecology... D12 Fluoroscopy - By physician With or Without Spot Films... D13 Special Examinations... D14 Bone Mineral Density (BMD) Measurement... D15 Computed Tomography (CT)... D17 Miscellaneous Examinations... D21 E. Clinical Procedures associated with Diagnostic Radiological Examinations Preamble... E1 Angiography... E2 Miscellaneous Procedures... E3 F. Magnetic Resonance Imaging (MRI) Preamble... F1 ii
3 G. Diagnostic Ultrasound TABLE OF CONTENTS Preamble... G1 Head and Neck... G3 Thorax, Abdomen and Retroperitoneum... G4 Pregnancy... G5 Pelvis... G6 Vascular System... G7 Vascular Laboratory Fees... G9 Miscellaneous... G10 Ultrasonic Guidance... G11 H. Pulmonary Function Studies Preamble... H1 J. Diagnostic and Therapeutic Procedures Preamble... J1 Allergy... J4 Anaesthesia... J6 Cardiovascular... J7 Electrocardiography (ECG)... J12 Non-Invasive Cardiography... J16 Echocardiography... J17 Echocardiography... J18 Critical Care... J21 Dermatology... J29 Dialysis... J30 Endocrinology and Metabolism... J33 Gastroenterology... J35 Gynaecology... J37 Haematology... J39 Home and Self Care Services... J40 Injections or Infusions... J41 Laboratory Medicine... J47 Nephrology... J53 Nerve Blocks for Acute Pain Management... J54 Nerve Blocks - Interventional Pain Injections... J58 Nerve Blocks - Peripheral/Other Injections... J62 Neurology... J65 Neurosurgery... J68 Ophthalmology... J70 Otolaryngology... J77 Palliative Care... J81 Physical Medicine... J83 Psychiatry and Respiratory Disease... J85 Sleep Studies... J86 Urology... J92 K. Obstetrics Preamble... K1 Prenatal Care... K4 Labour - Delivery... K6 Obstetrical Anaesthesia... K8 High Risk Pregnancies... K9 Maternal - Fetal Procedures... K10 iii
4 SP. Surgical Preamble TABLE OF CONTENTS Preamble... SP1 M. Integumentary System Surgical Procedures Skin and Subcutaneous Tissue... M1 Operations of the Breast... M18 N. Musculoskeletal System Surgical Procedures Preamble... N1 General Fees... N3 Hand and Wrist... N6 Elbow and Forearm... N13 Shoulder, Arm and Chest... N18 Skull and Mandible... N22 Pelvis and Hip... N31 Femur... N35 Knee... N37 Fibula and Tibia... N41 Foot and Ankle... N43 P. Respiratory Surgical Procedures Nose... P1 Accessory Nasal Sinuses... P3 Larynx... P5 Trachea and Bronchi... P6 Chest Wall and Mediastinum... P8 Lungs and Pleura... P9 Q. Cardiovascular Surgical Procedures Preamble... Q1 Heart and Pericardium... Q2 Valves... Q8 Arteries... Q9 Veins... Q14 R. Haematic and Lymphatic Surgical Procedures Spleen and Marrow... R1 Lymph Channels... R2 S. Digestive System Surgical Procedures Oral Cavity and Pharynx... S1 Salivary Glands and Ducts... S3 Lips... S4 Endoscopic Ultrasound... S5 Oesophagus... S6 Stomach... S9 Intestines (Except Rectum)... S13 Miscellaneous... S19 Rectum... S20 Liver... S23 Biliary Tract... S24 Pancreas... S26 Abdomen, Peritoneum and Omentum... S27 iv
5 T. Urogenital and Urinary Surgical Procedures Preamble - Kidney and Upper Urinary Tract... T1 Kidney and Upper Urinary Tract... T2 Preamble - Bladder and Urethra... T6 Bladder... T7 Urethra... T10 U. Male Genital Surgical Procedures Penis... U1 Testis... U2 Epididymis and Tunica Vaginalis... U3 Scrotum... U4 Vas Deferens... U5 Spermatic Cord and Seminal Vesicles... U6 Prostate... U7 V. Female Genital Surgical Procedures Preamble... V1 Vulva and Introitus... V2 Vagina... V3 Cervix Uteri... V6 Corpus Uteri... V7 Fallopian Tube... V9 Ovary... V10 W. Endocrine Surgical Procedures Thyroid Gland... W1 Parathyroid, Thymus and Adrenal Glands... W2 X. Neurological Surgical Procedures Cranial... X1 Peripheral Nerves... X8 Y. Ocular and Aural Surgical Procedures Eyeball... Y1 Cornea... Y2 Sclera, Iris and Ciliary Body... Y3 Crystalline Lens... Y4 Vitreous... Y5 Retina and Extra Ocular Muscles... Y6 Orbit... Y7 Eyelids... Y8 Conjunctiva... Y10 Lacrimal tract... Y11 External Ear... Y12 Middle Ear... Y14 Inner Ear... Y15 Z. Spinal Surgical Procedures Preamble... Z1 Anterior Spinal Decompression... Z2 Anterior Spinal Arthrodesis Following Decompression... Z3 Anterior Spinal Arthrodesis With Instrumentation Without Decompression... Z4 Posterior Spinal Decompression... Z5 v
6 Posterior Spinal Arthrodesis Following Decompression or Osteotomy... Z6 Posterior Spinal Arthrodesis As Sole Procedure... Z7 Fractures of the Spine... Z8 Tumours/Infections of the Spine... Z9 Deformities of the Spine... Z10 Revision Procedures for Spinal Surgery... Z11 Procedures on Musculoskeletal Elements... Z12 Procedures Involving Neural Elements... Z13 Meningocoele and Myelomeningocoele... Z15 AA. Appendix A AB. Appendix B AC. Appendix C AD. Appendix D Surface Pathology... AD2 Sub-Surface Pathology... AD5 AF. Appendix F AG. Appendix G AH. Appendix H AQ. Appendix Q NI. Numeric Index vi
7 GENERAL PREAMBLE Introduction...1 Definitions...2 General Definitions...2 Maximums, Minimums and Time or Unit-Based Services...5 General Information...6 Services Insured by OHIP...6 Modifications to the Schedule...6 Medical Research...6 Medical Records...6 General Payment rules...7 Specialist services...7 Use of Codes, Prefixes and Suffixes...7 Independent Consideration (IC)...8 Constituent and Common Elements of Insured Services...9 Specific Elements of Assessments...11 Consultations...12 Consultation...12 Repeat Consultation...13 Limited Consultation...13 Emergency Room (ER) Physician Consultation...13 Special Surgical Consultation...13 Assessments...14 General Assessment...14 Periodic Health Visit...14 General Re-Assessment...14 Pre-dental/Pre-operative assessments...15 Specific Assessment and Medical Specific Assessment...15 Specific Re-Assessment and Medical Specific Re-Assessment...15 Complex Medical Specific Re-Assessment...15 Partial Assessment...16 Chronic Disease Assessment Premium...16 Level 1 Paediatric Assessment...18 Level 2 Paediatric Assessment...18 Intermediate Assessment...18 Intermediate Assessment Pronouncement of Death...18 Minor Assessment...18 Periodic Oculo-Visual Assessment...19 First Visit by Primary Care Physician After Hospital Discharge...19 Detention...20 Detention-in-Ambulance...21 Detention for the Transport of Donor Organs...21 Newborn Care...21 Low Birth Weight Baby Care...21 Well Baby Care...22 Psychiatric Assessment under the Mental Health Act...22 E-Assessments...23 Hospital and Institutional Consultations and Assessments...26 Acute Care Hospital Non-Emergency In-Patient Services ( C prefix services)...26 Admission Assessment General Requirements...26 i
8 GENERAL PREAMBLE Admission Assessments by Specialists:...26 Admission Assessments by General and Family Practitioners:...26 Admission Assessments by General and Family Practitioners in an Emergency Department Funded under an Emergency Department Alternative Funding Agreement:...26 Admission Assessments by Emergency Physicians:...27 Admission Assessment by the Most Responsible Physician (MRP) Premium...27 Subsequent Visit...28 Subsequent visit by the MRP day following the hospital admission assessment (C122)...29 Subsequent visit by the MRP second day following the hospital admission assessment (C123)...29 Subsequent visit by the MRP - day of discharge (C124)...30 First subsequent visit by the MRP following transfer from an Intensive Care Area (C142)...31 Second subsequent visit by the MRP following transfer from an Intensive Care Area (C143)...31 Subsequent visit and palliative care visit by the MRP premium...32 Concurrent Care...32 Supportive Care...32 Long-Term Care Institution: Non-Emergency In-Patient Services...33 Admission Assessment...33 Subsequent Visit...33 Emergency Department - H prefix emergency department services...34 Palliative Care Assessment...34 Monthly Management of a Nursing Home or Home for the Aged Patient...35 Psychotherapy, Psychiatric and Counselling Services...37 Psychotherapy/Family Psychotherapy...38 Hypnotherapy...39 Counselling...39 Individual Counselling...39 Group Counselling...39 Transplant Counselling...40 Counselling of Relatives on Behalf of a Catastrophically or Terminally Ill Patient...40 Rehabilitation Counselling...40 Interviews...41 Delegated Procedure...42 Age-Based Fee Premiums...43 Special Visit Premiums...44 Team Care in Teaching Units...53 Surgical Assistants Services...54 Calculation of Fee Payable: Basic Units and Time Units...54 After Hours Premiums...55 Replacement Surgical Assistant...55 Special Visit Premiums...56 Cancelled Surgery Assistant Services...57 Second Assistant...57 Surgical Assistant Standby...57 Anaesthesiologists Services...58 Calculation of Fee Payable Basic and Time Units...58 After Hours Premiums...59 Special Visit Premiums...59 Cancelled Surgery - Anaesthesia Services...60 Second Anaesthesiologist...60 Replacement Anaesthesiologist...60 ii
9 GENERAL PREAMBLE Obstetrics Continuous Conduction Anaesthesia...60 Extra Units...61 Replacement of Listed Basic Units...62 Supportive Care/Monitoring By Surgical Assistant or Anaesthesiologist...64 Calculation of Fee Payable...64 Other Premiums...65 After Hours Procedure Premiums...65 After Hours Special Visit Premiums...67 Trauma Premium...68 Emergency Department Sessional Fees...69 Emergency Department Alternative Funding Agreements...71 iii
10 GENERAL PREAMBLE NOT ALLOCATED iv
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