General Practice BILLING GUIDE - British Columbia Medical ...

A GP SERVICES COMMITTEE INCENTIVES
BILLINGS: In addition to billing the 14016 for the conferencing with the palliative
care nurse to institute a care plan as well as to change the care plan as the patient’s
condition deteriorated, you are able to bill a call-out fee and out-of-office hours visit
fee for seeing the patient. You go to the home even though the nurse can pronounce
death. MSP allows you to bill for this immediate visit after death to the now-deceased
patient. Any family members needing your care for their own health needs are billable
under their own PHN (00103 if weekdays 0800 – 1800 hr or out-of-office fees if
outside these hours).
Date Time # of Services Fee Code Diagnostic Code
Tuesday 1830 01200 V58
Tuesday 16200 V58
Tuesday 1900 – 1945 2 14016 V58
Wednesday 1200 – 1215 1 14016 V58
Friday 1 16200 V58
Monday 1615 00103 V58
Monday (wife’s own PHN) 00104 311
Example #8:
Mrs. S is an 83-year-old patient with diabetes, CHF, hypertension, deafness, and gout.
She is seen in the office at 11:00 am for her CPX and complex care planning. Her
daughter has noticed increased bruising. In reviewing her medications it is noted she
has been using more of her diuretics than she should. She has postural hypotension
on clinical examination. She and her daughter are in agreement that her meds
need to be blister-packed and she needs to have an urgent assessment by the elder
outreach team. As part of the complex care planning process, you review her level of
intervention and ensure an end-of-life package is completed. You have also completed
the review of her flow sheets for diabetes and CHF and find the anniversary date for
billing these is today. Under the revised complex care single option, you advise Mrs. S
and her daughter that some of her follow-up may be done by phone if she is unable
to come into the office. Following the visit at 11:45 am you contact the elder outreach
intake nurse as well as the community pharmacist to discuss, revise, and implement
the home care plan. You then contact the daughter to discuss the results of these
phone calls, indicating that not only will her mother have a full needs assessment from
home care nursing, but also from the home care occupational therapist to ensure
her home is safe. You spent 25 minutes in the conferencing with the allied health
professionals and Mrs. S’s daughter.
A/22
GENERAL PRACTICE BILLING GUIDE