K034

PDF page 188 / A60

Long-Term Care Health Assessment Form
     The service rendered for completion and submission of a health assessment form to Ontario
     Health atHome on behalf of a patient who is applying for admission to a Long-Term Care
     facility.
 K038 Completion of Long-Term Care health assessment form .......                 46.35
    Immediate telephone reporting - specified reportable disease to the Medical Officer of
    Health
      Telephone reporting of a specified reportable disease to a Medical Officer of Health (MOH) is
      the service of immediately providing all available information to a MOH in order to comply with
      the requirements of the Health Protection and Promotion Act and/or any applicable regulations,
      and includes providing, by any method, any subsequent information to a MOH regarding a
      previous report related to the same reported disease within the 12 month period.
 K034 Telephone reporting - specified reportable disease to a MOH                   36.00
     Payment rules:
     1.K034 is limited to a maximum of one service per physician, per patient, per specified
       reportable disease, per 12 month period.
     2.K034 is only eligible for payment when the telephone report is personally rendered by the
       physician.
     3.K034 is only eligible for payment for the following specified reportable diseases:
       anthrax, botulism, brucellosis, cholera, novel coronavirus (including SARS and MERS),
       cryptosporidiosis, cyclosporiasis, diphtheria, primary viral encephalitis, food poisoning (all
       causes), symptomatic giardiasis, invasive Haemophilus influenzae type b disease,
       Hantavirus pulmonary syndrome, hemorrhagic fevers (e.g. Ebola, Lassa, Marburg and other
       viral causes), hepatitis A, legionellosis, listeriosis, measles, acute bacterial meningitis,
       invasive meningococcal disease, paratyphoid fever, plague, acute poliomyelitis, Q fever,
       rabies, rubella, shigellosis, smallpox, invasive group A streptococcal infections, tularemia,
       typhoid fever, verotoxin-producing E. coli infection indicator conditions (e.g. haemolytic-
       uremic syndrome), and West Nile virus illness
     Medical record requirements:
     K034 is only eligible for payment if the patient record demonstrates that the required
     information of the report related to one of the specified reportable disease has been
     communicated immediately by telephone to the MOH.
     [Commentary:
     1. For payment purposes, an immediate telephone report to a MOH includes a report provided
       to a delegate of a MOH.
     2.For payment purposes, the specified list of diseases has been identified as requiring an
       immediate telephone report.]

Master, record 2912. Record Layout PDF, page 1.

K03420250401999999990000036000000000000000000000000000000000000000000000000

Auxiliary master fields are preserved as raw scaled values. The linked layout calls them zero-filled, but this edition contains non-zero values. They are not presented as final dollar fees or PDF units.