1What Is the K737 OHIP Code?
What is K737?
K737 is a billing code used by consultant physicians participating in CritiCall telephone consultations, chiefly while on duty in an emergency department or urgent care clinic. This service involves discussing patient management and the potential transfer of critically ill patients.
Such calls are distinct because they require coordination for patient stabilization and transfer feasibility. Consultants may bill K737 in these scenarios instead of using K733, which applies to office settings. It's important to distinguish between these to ensure accurate billing.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A914 | GP focused practice comprehensive consultation by Video | Billing by family practice for comprehensive consultations via video. | |
| A006 | Repeat consultation | Billing by family practice for repeat consultations. | |
| A010 | GP focused practice consultation by Video | Billing by family practice for consultations via video. | |
| A011 | GP focused practice repeat consultation by Video | Billing for repeat consultations via video for family practice. |
3Eligibility Requirements
Eligibility for Billing K737
To be eligible for payment, the following criteria must be met:
- CritiCall Context: The service must involve a CritiCall telephone consultation for managing and transferring critically ill patients.
- Setting: This code is intended for use while the consultant is on duty in an emergency department or urgent care.
- Billing Frequency:
- A maximum of 2 K732 or K736 services (any combination) per patient, per day.
- A maximum of 1 K733 or K737 service per physician, per patient, per day.
- A maximum of 3 K733 or K737 services (any combination) per patient, per day.
- An additional E150 service may also be billed per physician, per patient, per day.
- Service Inclusions: Consultant physicians must review all relevant data shared by the referring physician or nurse practitioner and provide comprehensive management advice.
4What Your Clinical Note Must Show
Ensure your documentation reflects the following:
- Confirmation that consultation occurred through CritiCall.
- Details of patient management advice given.
- Relevance to a critical patient transfer or stabilization discussion.
- Review and inclusion of data provided by the referring physician.
5Weak vs. Strong Note Examples
The strong note provides specific details about the patient’s condition, setting, and comprehensive guidance, making it clear why K737 applies. The weak note lacks specific patient data and detailed management advice.
Provided consultation via CritiCall. Advised on patient transfer.
Conducted CritiCall consultation while on emergency department duty. Discussed stabilizing for potential transfer of critically ill patient with severe respiratory distress.
Reviewed comprehensive data transmitted by referring physician and advised on immediate management interventions and logistics of patient transfer.
- Clear setting of interaction (emergency/urgent duty).
- Specific patient condition description.
- Detailed advice provided for management and transfer steps.
