The Ministry of Health and Long -Term Care has amended regulations under the Public Hospitals Act to allow hospitals to grant expanded admitting privileges to oral and maxillofacial surgeons.  Amendments have also been made to regulations under the Health Insurance Act to ensure that certain hospital services will be insured when a patient is admitted solely by an oral and maxillofacial surgeon. To support those expanded hospital admission privileges, oral and maxillofacial surgeons will be allowed to order specific laboratory and diagnostic tests when performed at a hospital for a hospital in-patient or out-patient where the oral and maxillofacial surgeon reasonably believes that the person will require medically necessary hospital admission for a dental surgical procedure.

 To accommodate these inclusions, the Schedule of Benefits for Physician Services has been amended effective September 1, 2001. Oral and maxillofacial surgeons will be able to order specific diagnostic tests under Nuclear Medicine, Diagnostic Radiology, Diagnostic Ultrasound, Pulmonary Function Studies and Diagnostic and Therapeutic Procedures for their patients when performed in the hospital or in the hospital out-patient department where the oral and maxillofacial surgeon reasonably believes that the person will require medically necessary hospital admission for a dental surgical procedure.  Diagnostic services on in-patients are not paid on a fee-for-service basis but are included in the hospital’s global budget. Diagnostic services ordered by a dentist or oral and maxillofacial surgeon performed in an independent health facility, community laboratory or private physician’s office are uninsured under all circumstances.

 The specific diagnostic tests are as follows:

Claims Submissions:

Any claims for services requested by an oral and maxillofacial surgeon other than those listed above will not be paid.  To ensure proper processing, the services requested by the oral and maxillofacial surgeons should be submitted separately from the other claims.

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