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Common GP Billing Codes - BC May 2016 Page 1 - …

Common GP Billing Codes - BC May 2016 Page 1 - in office Compiled by Eugene Leduc MD CCFP. Office visits code Amt$ Some office tests and injections code Amt$. Visit (age 0-1) 12100 *Interpretation ECG 00117 Visit (age 2-49) 00100 *Peak flow 00930 Visit (age 50-59) 15300 *Hemoglobin 15000 Visit (age 60-69) 16100 *Glucose 15100 Visit (age 70-79) 17100 *Occult blood, stool 15110 Visit (age 80+) 18100 *Pregnancy test, urine 15120 Complete examination (age 0-1) 12101 *Urine analysis 15130 Complete examination (age 2-49) 00101 *Fungal KOH microscopic exam 15136 Complete examination (age 50-59) 15301 *Vaginal smear microscopic exam 15141 Complete examination (age 60-69) 16101 *Pinworm ova microscopic exam 15134 Complete examination (age 70-79) 17101 *Aspiration Joints 00757 Complete examination (age 80+)

Common GP Billing Codes - BC May 2016 Page 1 - in office Compiled by Eugene Leduc MD CCFP Office visits Code Amt$ Some office tests and injections Code Amt$

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Transcription of Common GP Billing Codes - BC May 2016 Page 1 - …

1 Common GP Billing Codes - BC May 2016 Page 1 - in office Compiled by Eugene Leduc MD CCFP. Office visits code Amt$ Some office tests and injections code Amt$. Visit (age 0-1) 12100 *Interpretation ECG 00117 Visit (age 2-49) 00100 *Peak flow 00930 Visit (age 50-59) 15300 *Hemoglobin 15000 Visit (age 60-69) 16100 *Glucose 15100 Visit (age 70-79) 17100 *Occult blood, stool 15110 Visit (age 80+) 18100 *Pregnancy test, urine 15120 Complete examination (age 0-1) 12101 *Urine analysis 15130 Complete examination (age 2-49) 00101 *Fungal KOH microscopic exam 15136 Complete examination (age 50-59) 15301 *Vaginal smear microscopic exam 15141 Complete examination (age 60-69) 16101 *Pinworm ova microscopic exam 15134 Complete examination (age 70-79) 17101 *Aspiration Joints 00757 Complete examination (age 80+)

2 18101 *Aspiration Cyst/Bursa 00761 Counselling (age 0-1), 4/yr 12120 *Injection, joint/bursa/tendon 00015 Counselling (age 2-49) 4/yr 00120 *Injection, approved vaccines (see fee guide) 100xx Counselling (age 50-59) 4/yr 15320 * Indicates billable at full value in addition to visit fee Counselling (age 60-69) 4/yr 16120 Counselling (age 70-79) 4/yr 17120 Injection, subcutaneous (max 3) 00034 Counselling (age 80+) 4/yr 18120 Injection, intramuscular 00010 Mental Health Mgmt Plan (30 min) 14043 Injection, intravenous 00011 Counselling, MHMgmt (age 2-49) 4/yr 14044 Vein puncture 00012 Counselling, MHMgmt (age 50-59) 4/yr 14045 Artery puncture 00755 Counselling, MHMgmt (age 60-69) 4/yr 14046 Phlebotomy for polycythemia 00019 Counselling, MHMgmt (age 70-79) 4/yr 14047 Counselling, MHMgmt (age 80+) 4/yr 14048 Counselling, group, first hour 00121 Some Common Minor Procedures Counselling, group, second hour 00122 Pelvic exam and PAP, routine +T1 14560 Consultation, (age 0-1) 12110 Insertion IUD and PAP +T3 14540 Consultation, (age 2-49) 00110 Cryo or other treatment of skin lesions +T1 00190 Consultation, (age 50-59) 15310 Anoscopy 10710 Consultation, (age 60-69) 16110 Biopsy skin/mucosa, excisional +T3 13600 Consultation, (age 70-79)

3 17110 I & D superficial abcess +T2 13605 Consultation, (age 80+) 18110 Laceration or Foreign Body, no anesth +T2 13610 Palliative Care Planning Fee 14063 Laceration or Foreign Body with anesth +T3 13611 HIV-AIDS in or out of office, per half hour 13015 Laceration >5cm per cm +T3 13612 Pre-Anesthetic Evaluation GP 13052 Excision skin tumour/scar, benign +T3 13620 Additional lesions (max 5) 13621 Some WCB Services Excision skin tumour/scar, malignant +T3 13622 WCB - Form 8 (First Report-Elec within 3 d) 19937 Paronychia, I&D +T2 13630 WCB - Form 11 (Progress Report-Elec 3d) 19902 Removal nail, simple +T2 13631 WCB - Form 8 (First Report - Requested) 19927 Removal nail + nail bed ablation +T3 13632 WCB - Request for copies (faxed within 3d) 19904 Wedge excision of one nail +T3 13633 WCB - Request and review records 19953 Haemorrhoid, Thrombosed, Enucleation +T3 13650 WCB - Return to work consult & Form 11 19950 Breast, fine needle aspiration +T3 70041 WCB - telephone (with adjuster) up to 15min 19930 Breast, fine needle aspiration, additional 70042 WCB - telephone (with WCB MD)

4 19508 Endometrial Biopsy +T3 00785 WCB - approve return-to-work plan 19976 Plaster Cast Arm +T3 51016 Plaster Cast Leg +T3 51019 BC Forms BC Disability Benefit Form Section 2 96501 Tray Fees - billable in office only BC Disability Benefit Form Section 3 96502 T1 - Mini tray fee 00044 BC Nutritional Supplement Form 96400 T2 - Minor tray fee 00080 BC MHR Employability Form 96503 T3 - Major tray fee 00090 BC MHR Multiple Barriers 96504 BC MHR Child Disability HR3103 96505 Annual Bonus Fees (anniversary Billing ). OSMV Medical Fitness to Drive (blue form) 96220 Chronic Care Incentive Bonus - Diabetes 14050 Chronic Care Incentive Bonus - CHF 14051 Telephone Advice Chronic Care Incentive Bonus - Hypertension 14052 Phone - Anticoagulation Advice 00043 Chronic Care Incentive Bonus - COPD 14053 Phone about patient in Community Care 13005 Maternity Network Bonus - per quarter 14010 Phone First Nations pt in Community Care 13000 Hospital Network Bonus - per quarter 14086 Phone/email advice to attached pts 14076 New Attached Complex Patient (referred) 14074 Phone/email planning for complex pts (max 5/y)14079 Planning and Management Bonus Fees (per calend year).

5 Conferencing Fees Prevention Plan (max 100 per doctor/year) 14066 Conferencing fee - per 15 min - max 18/yr 14077 Mental Health (30 min) 14043 GP urgent call to specialist 14018 Complex Care Management Plan 14033 GP support call to nurse practitioner 14019 Frailty Management Plan (V15) 14075 Palliative Care Management Plan 14063 Common GP Billing Codes - BC MSP May 2016 Page 2 - Out of office Compiled by Eugene Leduc MD CCFP. Services Mainly Performed Out of Office code Amt$ Obstetrics code Amt$. Visit, Home, specially called 00103 Visit, first prenatal 14090 Visit, Hosp, admission, MRP care 00109 Visit, subsequent pre-natal (max 14x) 14091 Visit, Hosp, first of day, MRP care 00108 Visit, post-natal office, (max 1) 14094 Visit, Hosp, subsequent, MRP care, 30d > 2/wk 13008 Prolonged 2nd stage (per 30 min >2 hr) 14199 Visit, Hosp.

6 Terminal, MRP care 00127 Delivery and post-natal care 14104 Visit, Hosp, supportive care, 10d > 1/wk 13028 Bonus to 14104 (first 25 deliveries of year) 14004 Visit, Hosp, courtesy, first of day 13339 Labour management and transfer to higher level 14105 Visit, Hosp, courtesy 13228 Bonus to 14105 (first 25 deliveries of year) 14005 Visit, Emergency, called 0800-1800 00112 Attendance at emerg C/S + postnatal care 14109 Visit, Nursing Home, first of day, MRP 13114 Bonus to 14109 (first 25 deliveries of year) 14009 Visit, Nursing Home MRP 00114 Attendance at C/S for baby only 00118 Visit, Nursing Home MRP, specially called 00115 Post-natal care after elective c/section 14108 Unattached Inpatient Care Bonus 14088 Bonus to 14108 (first 25 deliveries of year) 14008 Newborn Care, Routine, in 00119 Visit (age 0-1) (out of office) 12200 Foetal heart strip interpretation, antepartum only 00790 Visit (age 2-49) "" 13200 Visit (age 50-59) "" 15200 Time Sensitive Items - Out of Office Visit (age 60-69) "" 16200 evening = 1800 - 2300 hrs Visit (age 70-79) "" 17200 night = 2300 - 0800 hrs Visit (age 80+) "" 18200 Complete Exam (age 0-1) (out of office)

7 12201 Visit, Hosp, on-call, on-site, evening 00113 Complete Exam (age 2-49) "" 13201 Visit, Hosp, on-call, on-site, night 00105 Complete Exam (age 50-59) "" 15201 Visit, Hosp, on-call, on-site, weekend/hol 00123 Complete Exam (age 60-69) "" 16201 Complete Exam (age 70-79) "" 17201 Out-of-Office Hours Call-Out Surcharges*. Complete Exam (age 80+) "" 18201 Call out - evening 01200 Counselling (age 0-1) (out of office) 12220 Call out - night 01201 Counselling (age 2-49) "" 13220 Call out - weekend/hol 01202 Counselling (age 50-59) "" 15229 * apply according to time called Counselling (age 60-69) "" 16220 Counselling (age 70-79) "" 17220 Continuing Care Surcharges*.

8 Counselling (age 80+) "" 18220 Nonsurgical - evening, per 30 min 01205 Consultation (age 0-1) (out of office) 12210 Nonsurgical - night, per 30 min 01206 Consultation (age 2-49) "" 13210 Nonsurgical - weekend/hol, per 30 min 01207 Consultation (age 50-59) "" 15210 Surg - evening, up to Max 01210 Consultation (age 60-69) "" 16210 Surg - night, up to Max 01211 Consultation (age 70-79) "" 17210 Surg - wkndd/hol, up to Max 01212 Consultation (age 80+) "" 18210 *apply if called out, after first 30 min Consultation, special in-hospital 00116 Critical Care*. Surgical Assitant Fees Emergency Bedside Care per 30 min 00081 Surgical Assistant (surg fee < $316) 00195 Critical care monitoring per 30 min 00082 Surgical Assistant (surg fee $316 - 527) 00196 Crisis Intervention per 30 min 00083 Surgical Assistant (surg fee > $527) 00197 Accompanying patient per 30 min 00084 Surgical Ast (after 3 hours) per 15 min 00198 * apply after first 30 min if consult/visit fee First surgical assist of the day bonus 13194 GPSC Special Diagnostic Codes Neuro and Resp N519 Res and CHF R428 IHD and Kidney Dis I585 Diabetes and Liver D573.

9 Neuro and IHD N414 Resp and Diabetes R250 IHD and Liver I573 CVD and Kidney Dis C585. Neuro and CHF N428 Resp and CVD R430 CHF and Diabetes H250 CVD and Liver C575. Neuro and Diabetes N250 Resp and Kidney Dis R585 CHF and CVD H430 Kidney Dis and Liver K575. Neuro and CVD N430 Resp and Liver R573 CHF and Kidney Dis H585. Neuro and Kidney Dis N585 IHD and CHF I428 CHF and Liver H573 Frail Elderly V15. Neuro and Liver N573 IHD and Diabetes I250 Diabetes and CVD D430 Palliative Care V58. Resp and IHD R414 IHD and CVD I430 Diabetes and Kidney Dis D585 Maternity Network V26.


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