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    Health Service Code 03.01LH

    Physician to physician or podiatric surgeon telephone or telehealth videoconference or secure videoconference consultation, referring physician, weekdays 1700 to 2200 hours, weekends and statutory holidays 0700 to 2200 hours

    NOTE:

    Refer to notes following HSC 03.01LI.

    Additional notes:
    • Listed under 03.01LI - Physician to physician or podiatric surgeon telephone or telehealth videoconference or secure videoconference consultation, referring physician, any day 2200 to 0700 hours:
      1. HSCs 03.01LG, 03.01LH, 03.01LI may be claimed in addition to visits or other services provided on the same day by the same physician when criteria listed below are met.
      2. May only be claimed when the consultant has provided an opinion and recommendations for patient treatment as well as management after reviewing pertinent family/patient history and history of the presenting complaint as well as discussion of the patient's condition and management after reviewing laboratory and other data where indicated. It is expected that the purpose of the call will be to seek the advice of a physician or podiatric surgeon more experienced in treating the particular problem in question, and that the referring physician intends to continue to care for the patient.
      3. May not be claimed for situations where the purpose of the call is to:
        • arrange for transfer of care that occurs within 24 hours unless the patient was transferred to an outside facility and advice was given on management of that patient prior to transfer
        • arrange for an expedited consultation or procedure within 24 hours
        • arrange for laboratory or diagnostic investigations
        • discuss or inform the referring physician or podiatric surgeon of results of diagnostic investigations.
      4. A maximum of two (any combination of HSC 03.01LG, 03.01LH, 03.01LI) claims may be claimed per patient, per physician, per day.
      5. Documentation must be recorded by both the referring physician and the consultant in their respective records.
      6. Telehealth videoconferences may only be claimed when all participants are participating in the videoconference from regional telehealth facilities.
      7. Claims for secure videoconference may only be claimed when the service is provided using a secure videoconference system that is in compliance with the CPSA guidelines on secure electronic communication and when the physician/clinic has submitted a Privacy Impact Assessment for this service accepted by the Office of the Privacy Commissioner of Alberta.
    Category:V Visit
    Base rate:$36.45

    AMA billing tips:

    • Videoconference technology means communication via SECURE videoconferencing systems but not necessarily part of a telehealth videoconferencing service. This service may not be claimed for team conferences that occur via telephone.

    • The notes of the physician to physician phone call codes preclude claiming the service when the service is in regards to arranging lab or diagnostics or discussing results, the limitation on the phone calls also extends to discussions regarding which test or diagnostic to order.

    Fee modifiers:

    No modifiers.

    Governing Rules:

    No Governing Rules.