C020 – Complex dermatology assessment
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A complex dermatology assessment is an in-patient assessment for the ongoing management of specific complex dermatological diseases where the complexity of the condition requires continuing management by a dermatology specialist. It is subject to the same conditions and clinical criteria as the out-patient complex dermatology assessment (A020).
When to Use
- Use C020 for the initial in-patient assessment of a patient with >30% BSA psoriasis or dermatitis, provided you meet the 15-minute direct contact threshold.
- Use C020 when managing an in-patient with a complex systemic disease like SLE or vasculitis that presents with active, significant skin manifestations.
- Use C020 for the in-patient evaluation of a patient with a high-risk skin malignancy, such as a T1b+ melanoma, requiring immediate management planning.
Common Pitfalls
- Billing C020 for routine in-patient follow-ups that do not meet the strict 'complex' clinical criteria; these will be downgraded to C023 or C024 upon audit.
- Exceeding the 6-service annual limit per patient, which triggers an automatic adjustment to a lower assessment fee.
- Including chart review or administrative time toward the 15-minute requirement for complex psoriasis/dermatitis; only direct patient-facing time counts.
Billing Tips
- If you are the Most Responsible Physician (MRP) performing the admission assessment, pair C020 with the E082 premium to increase the fee by 30%.
- Ensure your chart notes explicitly document the complexity criteria (e.g., BSA percentage or specific systemic medication) to justify the C020 fee over the standard C023 specific assessment.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Non-Emergency Hospital In-Patient Services
Assessment
Must include all the elements of a specific assessment (as defined in ).
The patient must meet one of the specific clinical criteria for complex dermatology (see Patient Restrictions).
For virtual care, the service must be rendered via video (telephone is not permitted).
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