Escort of a Critically Ill Patient

Claims for this visit code must reflect the time in actual transit with the patient using the code listed for the service in the “Hospital Out-Patient and Emergency” Section for each specialty. Fee code 482 should be billed regardless of the point of origin or destination of the escort.

All Claims must be submitted IC and should include:

(a) the actual start and finish time for the in-transit period (finish time is defined by the time the patient is transferred to the care of a physician willing to accept responsibility of the patient), and 

(b) the critical nature of the illness requiring physician presence. 

A minimum of one unit should be claimed for any escort. Additional units may be claimed for each completed 15-minute period after the first 15 minutes.

General Assessments 

A General Assessment shall consist of a full history, an enquiry into, and an examination of all systems.

Note: 

The “clinical need” for a General Assessment rather than a Partial Assessment is also reviewed by the MCP Consultant’s Committee and such relevant notation should also be included in the patient’s record. 

For billing purposes, an appropriate record of a General Assessment shall contain information which highlights, at least the positive and significant negative findings for the past history, the functional enquiry and the physical examination. The patient record must show the findings with respect to the cardiovascular, respiratory, and digestive systems and also the findings for at least two of the following systems: genitourinary, musculoskeletal, hemolymphatic, ear-nose-throat, integumentary and nervous systems (central and peripheral).

Provided preamble requirements are met, a General Assessment can be claimed: 

(a) for the first ever visit for the purpose of initiating the use of the birth control pill. 

(b) when a physician admits a patient to hospital and performs the admission history and physical examination of all systems. 

(c) for evaluation of a patient whose acute condition(s) is/are such that based on signs and symptoms, examination of all systems is medically necessary.