General practice 14017 - General practice acute care discharge conference

General Info

Billing Amount: $40.00 per 15 minutes

This Item requires times

Max units / day / patient: 2

Max units / year / patient: 6

Description

In order to improve continuity of patient care upon discharge from an acute care facility, this incentive payment is available to the most responsible GP for that patient following discharge from the acute care facility. This fee is billable when a Discharge Planning Conference is performed upon the request of either an Acute Care facility, or by the GP accepting MRP status upon discharge, regarding a patient with complex supportive care needs, for review of condition(s) and planning for safe transition to the community or to a different facility; another acute care facility, or a supportive care or long-term care facility. - per 15 minutes or greater portion thereof

Notes:

Refer to Table 1 for eligible populations.

Payable only for patients being discharged from an acute care facility to the community or to a different facility; another acute care facility, or a supportive care or Long Term Care facility.

Must be performed in the acute care facility and results of the conference must be recorded in the patient’s chart in the acute care facility and the receiving GP’s office chart (or receiving facility’s chart in the case of inter-facility transfer).

iv) Face-to-face conferencing is required; the only exception is if a patient is being discharged from an acute care facility in a different community, and a chart notation must be made to indicate this circumstance.
v) Requesting care providers limited to: Facility-affiliated physicians and nurses, GP assuming MRP status upon patient’s discharge, care coordinators, liaison nurses, rehab consultants, social workers, any healthcare provider charged with coordinating discharge and follow-up planning.
vi) Requires interdisciplinary team meeting of the GP assuming MRP status upon discharge and a minimum of 2 other health professionals as enumerated above, and will include family members when appropriate.
vii) Fee includes:
a) Where appropriate, interviewing of and conferencing with patient, family members, and other health providers of both the acute care facility and community.
b) Review and organization of appropriate clinical information.
c) The integration of relevant information into the formulation of an action plan for the clinical care of the patient upon discharge from the acute care facility, including provision of Degrees of intervention and end of life documentation as appropriate.
d) The care plan must be recorded and must include patient identifiers, reason for the care plan, list of co-morbidities, safety risks, list of interventions, what referrals to be made, what follow-up has been arranged.
viii) This fee does not cover routine discharge planning from an acute-care facility, nor is this fee payable for conferencing with acute-care nurses during the course of a patient’s stay in the acute care facility.
ix) Maximum payable per patient is 90 minutes (6 units) per calendar year.Maximum payable on any one day is 30 minutes (2 units).
x) Claim must state start and end times of the service.
xi) If multiple patients are discussed, the billings shall be for consecutive, non-overlapping time periods.
xii) Not payable to physicians who are employed by or who are under contract to a facility who would otherwise have attended the conference as a requirement of their employment or contract with the facility; or physicians working under salary, service contract or sessional arrangements.
xiii) Medically required visits performed consecutive to the Acute Care Discharge Conference are payable. (i.e. Visit is separate from conference time).
xiv) Submit the new fee item G14017 through the MSP Claims System under the patient's PHN. The claim must include ICD-9 codes V15, V58, or the code for one of the major disorders.
xv) Not payable to the same patient on the same date of service as the Facility Patient Conference Fee (fee item G14015), Community Patient Conference Fee (G14016) or GP Attachment Conference Fee (G14077).
xvi) Not payable on the same day as any GPSC planning fees (G14033, G14075, G14043,G14063 (Palliative Planning Fee).

Pre-Amble References:

Please reference the billing pre-amble for these relevant interpretations of this billing code:

See Pre-Amble Notes