EMERGENCY MEDICINE OHIP CODES (December 2015)

Transcription

1 ASSESSMENT EMERGENCY MEDICINE OHIP CODES (December 2015) WKD & HOLIDAY NIGHT Minor H H H H Multiple systems H H H H Comprehensive H H H H Reassess (q2h) H H H H CRITICAL CARE LIFE THREATENING*: up to 3 MDs OTHER CRITICAL CARE*: 1 st 15 min G G nd 15 minutes G G391 (MAX 8 units) Further Reassess (q15min) G522 (MAX 4 units) *Includes IVs, arterial lines, endotracheal or NG intubations, urinary catheters, defibrillations, & cardioversions. AFTER HOUR CODES WKD ( ) & HOLIDAYS NIGHTS Procedures E % E % E % G & K N/A N/A H H TRAUMA PREMIUM: Applies to G codes & procedures. Medical record needs ISS score >15 or >12 if patient is < 16 yo. E % CRITICALL CONSULTATION: Min of 10 minutes spent discussing pt between referring MD & consult MD. Document the start/stop time of call, name of consultant MD, reasons for consult, opinion & recommendation of consultant MD. ED MD to NON CritiCALL K ED MD to CritiCALL telephone K ADMISSION H CONSULTATION H065 (CFPC) H055 (FRCPC) SPECIAL VISIT PREMIUM ( ) show max # of pts can be billed. *NIGHT is unlimited # pts TELESTROKE CONSULTATION: Services cannot be billed in addition to the premiums for a missed, cancelled, or abandoned session. First Telemedicine Patient Encounter premium Subsequent Telemedicine Patient Encounter Premium First Cancelled/Missed Telemedicine Patient Encounter premium Subsequent Missed/Cancelled Telemedicine Patient Encounter premium First Technical Difficulties Abandoned Patient Encounter premium Subsequent Technical Difficulties Abandoned Patient Encounter premium WKD & HOLIDAY B100A B200A B101A B201A B102A B202A NIGHT billed at H987. Travel Premium (max in H960 (2) H962 (2) H963 (4) H brackets) First Person Seen H H H H Add l Persons (max incl. 1 st pt) H981 (5) H985 (5) H989 (10) H987 * ASSESSMENT Bill with special visit premium codes. MINOR INTERMEDIATE GENERAL REASSESS A A A A AMBLANCE Ground (q15min) K Return w/out pt to place of origin (q30min) K

2 OTHER CRITICAL CARE PROCEDURES: (*) codes do not bill with G codes. Can bill with H Codes,. Abdominal Paracentesis (Therapeutic) Z Lumbar Puncture Z *ABG Z *NG Tube (Intubated pt) G *Arterial Line G *NG Tube Therapeutic G *Cardioversion (Chemical or Shock) Z *Pacing (External thoracic) G *Central Venous Line G Pacing (Transvenouse) Z Chest Tube Z Pericardiocentesis Z IM Injection G Thoracentesis (Therapeutic) Z Hypothermia Induction G Thoracotomy M Interosseus Insert G Tracheotomy Z *Intubation (endotracheal) G *Urinary Catheter Z ANESTHESIA: C suffix with Procedure Code Base units (min = 6) + physical time spent (per 15 min) = total # of units. (1 unit = $15.01). After hours , W/E, E400C +50% E401C Add 75% premiums: Holiday Age Premiums: Newborn < 37 GA E021C +9 units Newborn to 28d E014C +5 units 29 days-1 yo E009C +4 units 1-8 yo E019C +2 units yo E007C +1 unit 80 yo + E018C +3 units ASA premium: III E022C +2units IV E017C +10 units BMI premium: BMI >40 E010C +2 units Sitting Position (>60 ) E011C +4 units BEDSIDE ULTRASOUND (POCUS) For suspected pericardial tamponade, cardiac standstill, FF from trauma, ruptured AAA, or ruptured ectopic pregnancy. H100 (Max 2 scans/pt/day) FORMS Form 1 K Home Care Form (CCAC) K MOT K Death Certificate A Death Cert + Pronouncement A COUNSELLING: Counseling relatives of patient K terminally ill or post resus Counseling (q30min) can be K billed with same day H codes if there are 2 separate Dx for visit Counseling for Organ Donation K STD/Needle Stick (q30min) K Female Sexual Assault + Kit K Male Sexual Assault + Kit K POLICE BLOODWORK (court order) Blood samples (police request) K INCISION/DRAINAGE: Hematomas & Abscesses One Z Palmar/plantar space (+GA) Z One (+GA) Z Intramuscular Z Two Z Bursa/Soft Tissue Z Two or more (+GA) Z Perianal Z Three or more Z Perianal (+GA) Z Eyelid Z Thrombosed Hemorrhoid Z Nasal Z Ischiorectal/Pilonidal Z Oral Cavity Z Ischiorectal/Pilonidal (+GA) Z Pharyngeal Z Vulva, Bartholin, or Skene s gland Z Ear (packing/compression dressing) E Vulva, Bartholin, or Skene s gland (+GA) Z Palmar/plantar space Z Vaginal Z FB REMOVAL Skin Z Ear (simple) Z Nose (simple) Z Skin (+GA) Z Ear (compl/+ga) Z Nose (compl/+ga) Z Muscle R Ear Syringed G Rectum (+GA) Z Cornea (1) Z BPPV Maneuver G Vaginal (+GA) Z Cornea (2) Z Larynx (Direct) Z

3 NOSE: Epistaxis Cauterization Z Ante Packing Z Ante & Post Packing Z LACERATIONS Up to 5 cm Z Complex laceration repair (face) (20 min) Z Up to 5 cm Face/layers/bleeders Z Complex lac repair (digit) (20 min) Z cm Z Complex lac repair (digit zone 1) (20 min) Z cm Face/layers/bleeders Z Revision of amputated finger tip R cm Z Tendon repair, extensor R cm Face/layers/bleeders Z Tendon repair, extensor (each add l) E > 15.1 cm Z Tendon repair, flexor R > 15.1 cm Face/layers/bleeder Z Tendon repair, flexor (each add l) E Secondary Closure Z Muscle repair (incl. skin closure) R Adhesive glue, steri strips 50% of fee Earlobe laceration R NAIL EXCISION Partial or complete (1) Z Nail bed destruction Z Partial or complete (Multiple) Z Nail bed destruction (Multiple) Z WOUND DEBRIDEMENT: Min. 10 min of debridement. Suture codes do NOT apply. Extends to SQ tissue (1) Z Extends to SQ tissue (4 or more) Z Extends to SQ tissue (2) Z Extends to tendon, bone, ligament, bursa, or bone (1) Z Extends to SQ tissue (3) Z As above (2 or more) Z BURN DEBRIDEMENT Hand each digit R Hand Dorsum, Palm - each R Nose, cheek, lip, ear, forehead, scalp, neck eyelid - each R Debride & excision per % total body treated other than hand, head, or neck R NERVE BLOCKS: Can NOT bill in addition to suture codes or other procedures. For Exception see G224. Must last longer than 4 hours. Mental Branch G Infraorbital G Intercostal G Mandibular, Maxillary G Supraorbital G Intercostal nerve G EXCEPTION: Block allowed in addition to procedure for: Intercostal, Pudendal, Femoral, Sciatic, Illioinguinal, Ulnar, Median, Radial, Brachial. (each add l) G Illioinguinal or Iliohypoglastric G BURSA/JOINT INJ or ASPIRATION Injection G Each additional (max 5) G Aspiration G Each additional (max 2) G US guided after failed blind E attempt (ADD to fees above) US guided aspiration J149P CASTS/SPLINTS Finger Z Hand Z Wrist, Forearm, Arm Z Toes Z Foot, Ankle Z Leg, below knee Z Whole leg Z Cast Removal Z Cast Wedging Z DISLOCATIONS Finger (IP Joint) D E576 (each add l) MCP D E577 (each add l) Carpal D N/A Elbow D N/A Elbow (pulled), D N/A radial head Shoulder D D016 (+GA) AC/SC Joint D D025 (+GA) Toe (IP) Joint D E578 (each add l) MTP D E579 (each add l) Ankle D N/A Patella D D031 (+GA) Knee D N/A Hip D N/A TMJ D N/A Nasal F N/A

4 FRACTURES (UPPER EXTREMITY) NO REDUC CLOSED REDUC OTHER Phalanx F F E558 (each add l) Metacarpal F F E504 (each add l) Bennett s F F N/A Scaphoid F N/A N/A Carpus F F N/A Distal Radius (Colles, Smith s, Barton s) F F FO46 (+GA) Radius or Ulna F F N/A Radius or Ulna Shaft F F N/A Radius & Ulna (Monteggia) F F N/A Olecranon F F N/A Transcondylar or Condylar (Elbow) F F N/A Epicondyle F F N/A Humeral Tuberosity F F N/A Humerus Neck (no dislocation) F F N/A Humerus Neck (with dislocation) F F N/A Humerus Shaft F F N/A Scapula F N/A N/A FRACTURES (LOWER EXTREMITY) NO REDUC CLOSED REDUC OTHER Phalanx (toe) F F E Tarsus (not including calcaneus) F F N/A Calcaneus F F N/A Metatarsus F061 (+boot) F F062 (+cast) Ankle F F N/A Fibula F F N/A Tibia +/- Fibula F F N/A Patella F N/A N/A Femur Shaft (child/adult) N/A F094 (child) F095 (> 12 yo) OPTHALMOLOGY Cornea (1) Z Eyelid I & D (Abscess) Z Cornea (2) Z Tonometry G GI Anoscopy Z NG Tube Therapeutic G Fecal Disimpaction Z NG Tube insert (Intubated pt) G Gastrostomy Tube Change Z Paracentesis (diagnostic) Z Hemoccult Test G Paracentesis (therapeutic) Z Hernia reduction Z Rectum FB removal (+GA) Z UROLOGY Foley Catheter Z Manual catheter declotting & Bladder US (Post void residual) G bladder irrigation Z OBSTETRICS Non OBGYN MD assists L&D/CS or P Vaginal FB removal Z resuscitation of newborn Vaginal laceration P Pap smear G

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