BILLING FOR ME/CFS/FIBROMYALGIA

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ONTARIO NEW BILLING ANNOUNCEMENT FOR ME/CFS/FIBROMYALGIA:

NEW K037 OHIP BILLING CODE FOR ‘ FIBROMYALGIA / CHRONIC FATIGUE SYNDROME CARE ‘ IN ONTARIO

By: Audrey MacKenzie, R.N. ,

THE MYALGIC ENCEPHALOMYELITIS ASSOCIATION OF ONTARIO is pleased to inform you that ‘fibromyalgia/Chronic Fatigue Syndrome care’ has now the OHIP time-based billing Code number K037.

In the past, many physicians have refused to accept ME/CFS/FMS patients because “they took too long”. However, with this new code, physicians will be paid for the time they spend with patients who have these complex illnesses.

OHIP has notified all of Ontario’s Physicians of this new Code.

In addition, the new Diagnostic Code for CFS, number 795, picked up the newly diagnosed patient, but with the new K037 Code, patients who were previously diagnosed will be able to be recorded by OHIP, thus allowing future statistics to be collected on these illnesses in the Province of Ontario.

(We do recognize that there are areas in Ontario where there is such a severe shortage of physicians that ME/CFS and FMS patients still may not be able to have all the time they need in one visit.)

Many thanks to all who have helped this come about: Dr. Alison Bested for her excellent presentation to the Ontario Medical Association; the National ME/FM Action Network for initiating the Canadian ME/CFS and Fibromyalgia Definitions, Diagnostic and Treatment Protocols; the Board of Directors of The Myalgic Encephalomyelitis Association of Ontario for their meetings and advocacy with the Ontario Ministry of Health and our Members who have written, called their MPPs and written to the Ministry of Health; the Ontario Support Group Leaders and their Members and individuals throughout the province who have advocated on behalf of CFS. If I may borrow a phrase “it takes a village”.

Thanks everyone for all your hard work and efforts in having ME/CFS and FM accepted and recognized for the complex illnesses that they are by the Ontario Medical Association!!