1What Is the H102 OHIP Code?
A comprehensive assessment and care service (H102) in family medicine is designed for situations where a family physician conducts an in-depth evaluation of the patient during weekday daytime hours. This includes a detailed history, examination of all body systems, and the development of an appropriate management plan. A typical scenario would involve a patient presenting with multiple complex symptoms, necessitating a thorough investigation and personalized treatment approach.
This billing code is often missed when the documentation does not reflect the comprehensive nature required or when the service rendered does not meet the full criteria outlined by OHIP, such as missing a complete history or examination. Ensuring all components are captured in the patient records is crucial for billing this code accurately.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A914 | GP focused practice comprehensive consultation by Video | Refer to specific code rules for use | Comprehensive consultation via video for GP focused practice. |
| A006 | Repeat consultation | Refer to specific code rules for use | Follow-up consultation services. |
| A010 | GP focused practice consultation by Video | Refer to specific code rules for use | Consultation by video in GP focused practice. |
| A011 | GP focused practice repeat consultation by Video | Refer to specific code rules for use | Repeat consultation via video for GP focused practice. |
3Eligibility Requirements
To be eligible for billing the H102 code, the service must be provided in a location outside of the patient's home and during weekday daytime hours (08:00-17:00). The assessment requires a complete patient history, including the presenting complaint, family, past medical, and social history. A full examination of all body systems should be conducted unless certain examinations are not medically indicated or are refused by the patient.
Additionally, time must be recorded in the patient's permanent medical record, noting when the service began and ended, as this record is necessary for payment approval according to OHIP's requirements.
4What Your Clinical Note Must Show
Ensure the start and end times of the service are recorded in the patient's permanent medical record.
- Document the time service started.
- Document the time service ended.
5Weak vs. Strong Note Examples
The strong note provides a detailed account of the patient's history, the comprehensive examination conducted, and a clearly documented management plan, which are all crucial for justifying billing under the H102 code.
The patient was assessed. History taken and relevant systems examined. Plan discussed.
Patient presented with multiple complaints involving respiratory and gastrointestinal symptoms.
Full history taken, including family, past medical, and social history.
Comprehensive examination conducted: lungs clear, abdomen non-tender with normal bowel sounds.
Management plan includes lifestyle changes and follow-up in four weeks.
- Detailed history of presenting complaints.
- Comprehensive systems examination.
- Documented management plan and follow-up.
