New Billing Code in Canada Compensates MDs f/ Extra Time w/FMS/CF

Discussion in 'Fibromyalgia Main Forum' started by JLH, Sep 30, 2006.

  1. JLH

    JLH New Member

    New Billing Code in Canada Compensates MDs For Extra Time Spent with FM & CFS Patients ......

    Many physicians resist taking the extra time needed to test, diagnose, and experiment with therapies for difficult, complex illnesses such as Fibromyalgia or Chronic Fatigue Syndrome.

    Often a physician will shrug off FM/CFS patients, or have them return for multiple visits focused on individual problems. If the physician’s target time per-patient-visit is eight minutes, for example, the problem boils down to reimbursement.

    Now Ontario, Canada’s most-populated province, has instituted a new Health Insurance Plan billing code (number 795), which reimburses doctors for extended visits with FM and CFS patients. Use of the new code will also produce more detailed statistics on these illnesses.

    This decision resulted from the efforts of multiple advocacy groups, which collaborated to inform decision-makers in the Ontario Medical Association and Ministry of Health. Their next objective: similar coding changes in all the provinces.

  2. kjfms

    kjfms Member

    Interesting article I am not very familiar with Canada's medical coding system other than they have adopted the ICD-10.

    In the US we use the Evaluation and Management (E/M) codes from the Current Procedural Terminology (CPT) manual for office visits.

    There are codes for different levels of office visits which include amount of time a physician spends with a patient.

    All of which must have certain documented key components in order to be billed.

    Codes for diagnoses are from the IDC-9-CM.


    Karen :)
  3. Pianowoman

    Pianowoman New Member

    I am from Canada and I can tell you that my CFS doctor is very happy about this. She was part of the group that lobbied to get this. As a result, CFS patients will get more doctors' time and better care.

  4. kholmes

    kholmes New Member

    way to go, Canada!
  5. marsupialmama

    marsupialmama New Member

    Good news!! I should maybe print the article for my doc? :)
  6. Fudge43

    Fudge43 New Member

    I haven't heard of this .. and I was just at my doctor last week .. I'm printing it off and asking how it affects my particular case .. my GP is great and always spent time .. but perhaps there are other advantages to this we both need to know explore ..
    Thanks for the info !
  7. JLH

    JLH New Member

    I don't live in Canada, but I think they are on the right track by compensating doctors for extra time spent with FM & CFS patients !

  8. happycanuk

    happycanuk New Member

    I live in Canada and have not heard of this. I don't live in Ontario, though. Is it just provincial? My Dr. is very good with me in any case. He NEVER rushes through appointments, and sends me for all the necessary tests.
  9. Pianowoman

    Pianowoman New Member

    I believe that this new billing code is for Ontario. Since health care is a provincial matter, it will have to be negotiatied in the other provinces. Ontario also has a specific code for CFS, thus acknowledging the disease.

  10. shanwill

    shanwill Member

    Am printing this off to give to my doc.
    Very helpful to know - and such a good idea.
  11. pepper

    pepper New Member

    how much extra time is allowed per visit?


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