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Billing specialist advice when the specialist comes to see the patient

The scenario

You call ortho about a displaced ankle fracture. They advise you not to splint yet, then come down and reduce it themselves. Level 2 patient, evening shift. You are CCFP-EM.

How to bill it

Level 2 evening (01822) $102.88 + 14018 specialist advice $50.44 = $153.32. The advice code is billable even when the specialist ends up seeing the patient, as long as advice was given. Document the advice and the specialist's name. FRCPC would bill 78711 ($60.00) instead.

What to watch for

Does the specialist coming in cancel the advice code?

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