To see a full list of INFOBulletins, please visit the Ministry of Health website.
- Bulletin 231203
- Affected billing codes; E088, E518, E519, E520, Z516, Z517 and Z518
- Congestive Heart Failure premium – E088
- Add 50% of the approved value of A601, A603, A604 and A608
- Must be claimed with diagnosis 428 – Ischaemic and Other Forms of Heart Disease; Congestive Heart Failure
- Colonoscopic Polypectomy – E720, E520, E519 and E518
- Eligible for payment when billed with Z571, Z518, Z517 or Z516
- Only 2 of these codes are eligible for payment on the same day
- Units for each service contribute to the maximum of 2. For example, if E518 x 1 and E519 x 2 are claimed on the same day the claim has exceeded 2 services. To avoid rejection, submit either E519 x 2 or E518 x 1 and E518 x 1
- Polyp Excision – Z517 and Z518
- Only on of Z517, Z518, Z517 and Z516 is eligible for payment on the same day
- OHIP recommends submitting the appropriate code for the largest polyp that was excised
- Bulletin 240101 and Bulletin 240102
- Changes to Family Health Organization list of core services
- A010A, A011A, A906A, A913A, A914A, A913A, A814A, A817A and A818A have been removed from the basket of core services for the FHO
- Adjustments will be made on these services between December 1, 2022 and November 1, 2023
- No action is required by physicians
- Changes to Family Health Organization list of core services
- Bulletin 240103
- Patient-to-Physician Secure Messaging Proof-of-Concept Pilot
- MOH is implementing a 2-year pilot for patient-to-physician services by secure messaging, beginning April 1, 2024
- Messaging will be facilitated within the Ontario Virtual Care Program (OVCP), using Ontario Health’s Verified Solution List
- The pilot aims to:
- Complement care within existing patient-physician relationships;
- Increase access to care; and
- Gather a wider scale of evidence related to the use of secure messaging within physician practices in Ontario
- Physicians must register to submit claims for eligible secure messaging services
- Registered physicians must include K303 when billing for these services
- Access the OVCP: Secure Messaging Proof-of-Concept Pilot Billing Guide
- Bulletin 240104
- Payments for E518A, E519A, E520A, Z516A, Z517A and Z518A have been reprocessed by a Medical Claims Adjustment
- For more information see Bulletin 231203
- Bulletin 240105
- Affected billing codes: E202A, Z844A, E517A, E147A, E186A/C and E187A/C
- Changes were implemented January 1, 2024, effective April 1, 2023
- Intravitreal Injection Codes
- E147A has been replaced by:
- E186A/C – Intravireal injection of medication for the treatment of wet macular degeneration, left eye
- E187A/C – Intravitreal injection of medication for the treatment of wet macular degeneration, right eye
- Services not eligible for payment on the same day by the same physician as E186A and/or E187A:
- Z851A, Z844A, E149A
- When both E186A and E187A are submitted for the same patient on the same day by the same physician, the second service will be reduced to 85%
- E186C/E187C are eligible for 5 base units
- Services not eligible for payment on the same day as E186C or E187C, by any physician:
- E010C, E011C, E012C, E016C, E017C, E020C, E021C, E022C, E024C or E025C
- E003C
- Services not eligible for payment on the same day as E186C or E187C by the same physician:
- E023C
- E147A has been replaced by:
- E202A – Corneal cross-linking
- E202A is not eligible for payment to any physician on the same days as E117A
- Z844A – Diagnostic paracentesis for suspected intraocular infection, intraocular inflammation or uveitis, or suspected cancer involving the intraocular structures or fluids
- Z844 is not eligible for payment with Z581A, E147A and/or E149A when claimed by the same physician
- E175A – Therapeutic paracentesis, to E147A or E149A
- E175A is only eligible for payment when billed by the same physician on the same day as E147A or E149A
- E175A is not eligible for payment with Z581A