Psychiatry eConsultation Billing Codes

Referring physicians can bill Bill using eConsult code 03.01R (referring physician).

Advising specialist can bill using eConsult code 03.01O (advising physician)

03.01O Physician to Physician secure E-Consultation, consultant NOTE:

1. May only be claimed when both the request and response referring and consulting physician exchange communication are sent by using a secure email system electronic means. 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 acceptable to the Office of the Privacy Commissioner of Alberta. Please refer to the CPSA for email security guidelines. Physicians must be able to provide evidence of the proper use of email security guidelines.

2. This service is only eligible for payment if the consultant physician has provided an opinion/advice and/or recommendations for patient treatment and/or management within thirty (30) days from the date of the e-consultation request.

3. May only be claimed when initiated by the referring physician.

4. The consultant may not claim a major consultation, physician to physician phone call, or procedure for the same patient for the same condition within 24 hours of receiving the request for an e-consultation unless the patient was transferred from an outside facility and advice was given on management of that patient prior to transfer.

5. 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, history of the presenting complaint as well as laboratory and other data where indicated. It is expected that the purpose of the communication will be to seek the advice of a physician more experienced in treating the particular problem in question, and that the referring physician intends to continue to care for the patient.

6. May not be claimed for situations where the purpose of the communication is to:

• arrange for an expedited consultation or procedure within 24 hours except when the conditions in note 4 are met
• arrange for laboratory or diagnostic investigations
• discuss or inform the referring physician of results of diagnostic investigations.

7. Documentation of the request and advice given must be recorded by the consultant in their patient records.

8. This service may not be claimed for transfer of care alone

AMA Notes: 03.01O has been revised for consistency and to capture the necessary security details that are a part of electronic communications. This code is meant to compensate physicians for the time spent completing a consultation via electronic means. The intent is that the consultant would review the patients’ referral letter and work up and make recommendations about treatment to the referring physician without actually having seen the patient. You may use 03.01O only when you have completed the consultation using a secure electronic method such as secure electronic messaging, secure email or other secure electronic products that are accepted by the OIPC. See the portion of the Billing Corner titled “Are you prepared for electronic communication?”