Telephone Advice Take quiz

Fee items for telephone advice include 13000 and 13005.

Fee Item 13000 - Telephone Advice to a Community Health Representative in a First Nation's Community

Fee item 13000 can be used only when:

  1. Medical advice is provided by the physician by telephone to a Community Health Representative who initiated the medically required call; and
  2. A Community Health Nurse is not available in that community.
Billing Instructions for Fee Item 13000:

When submitting a claim for fee item 13000, bill under the personal health number (PHN) of the patient on the date that the service was rendered.

Fee Item 13005 - Advice about a Patient in Community Care

Fee item 13005 can be used only when medical advice is provided by the physician by telephone, fax or in written form about a patient in community care to an allied health care worker who initiated the call and is specifically assigned to that patient. Note that:

  1. Community care comprises Residential, Intermediate and Extended care, and includes patients receiving Home Nursing care, Home support, or Palliative care at home.
  2. Allied health care workers include:
    1. home care coordinators
    2. nurses (registered, licensed practical, public health and psychiatric)
    3. psychologists
    4. mental health workers
    5. physiotherapists
    6. occupational therapists
    7. respiratory therapists
    8. social workers
    9. ambulance paramedics, and
    10. pharmacists (other than for prescription renewal)
Billing Instructions for Fee Item 13005:

  1. When billing a claim under fee item 13005:
    1. bill the claim under the personal health number (PHN) of the patient
    2. include the time of day that the request for advice was received
  2. This fee may be billed only once per patient per physician per day.
  3. This fee cannot be used for advice in response to an enquiry by the patient or his/her family.
  4. This fee cannot be claimed in addition to a visit or other service provided on the same day to the same patient by the same physician.
  5. This fee may not be claimed by a physician who is:
    1. on third party call to a facility
    2. on-site, on-duty in an emergency department
    3. being paid on a sessional basis at that time
    4. working as a hospitalist at that time
    5. receiving non-fee-for-service compensation for providing coverage at a continuing care facility during normal business hours
  6. This fee item cannot be billed for calls about doctor of the day patients to a physician who is on call for doctor of the day at the time the request for advice is made.
  7. This fee item requires that the following documentation be maintained in the physician's office and recorded in the patient's file:
    1. date of service
    2. name of the allied health care worker who initiated the request
    3. a brief notation of the advice given or original fax or copy of written advice

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