1What Is the K736 OHIP Code?
K736 is an OHIP billing code designated for referring physicians participating in CritiCall telephone consultations. These consultations occur typically in emergency departments or hospital urgent care clinics, where timely specialist advice is crucial for patient management or determining patient transfer needs.
Family physicians use this code when they seek the expertise of a consultant physician via a telephone consultation facilitated by CritiCall Ontario. This setup allows immediate access to specialist input, which is vital for quickly addressing the often critical conditions presented in emergency settings.
Often missed, the K736 billing opportunity may be overlooked in the rush of emergency settings due to uncertainty about the specific requirements or confusion with similar codes, such as K732.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A914 | GP focused practice comprehensive consultation by Video | One per patient | Comprehensive video consultations in the family practice setting. |
| A006 | Repeat consultation | Per patient, as needed | Subsequent consultations within the same episode of care. |
| A010 | GP focused practice consultation by Video | Per patient, as needed | Standard video consultations in the family practice setting. |
| A011 | GP focused practice repeat consultation by Video | Per patient, as needed | Follow-up video consultations in the family practice setting. |
3Eligibility Requirements
To bill K736, the following eligibility requirements must be met:
- The telephone consultation must be arranged through CritiCall Ontario.
- The referring physician or nurse practitioner, along with the patient, must be in Ontario at the time of the consultation.
- Up to two K732 or K736 services, in any combination, are eligible per patient, per day.
- It's ineligible if the physician receives compensation through another means for participation in the call.
CritiCall consultations support best patient management in time-sensitive emergencies and provide crucial advice for patient transfer strategies.
4What Your Clinical Note Must Show
Ensure the following elements are documented in the medical record for billing K736:
- The consultation was arranged by CritiCall Ontario.
- Patient identification by name and health number.
- Referring and consultant physicians' identification.
- Reason for the consultation.
- Consultant's opinion and recommendations.
5Weak vs. Strong Note Examples
The strong note succeeds by providing detailed documentation of the consultation setup, purpose, and the specialist's advice. The weak note fails to capture necessary details like patient identity, specific consultation content, and advises given, risking billing rejection.
Patient seen with abdominal pain. Called CritiCall for consultation. Received advice.
CritiCall consultation arranged for 45-year-old male, John Doe, Health No. 1234567890, presenting with severe abdominal pain. Referred to Dr. Smith, Consultant. Discussed potential appendicitis management and advice on whether to transfer to surgical unit.
- CritiCall consultation arranged.
- Patient identified by name and health number.
- Consultant physician identified.
- Specific reason for consultation documented.
- Consultant's recommendations included.
