C022 – Subsequent visit - first five weeks
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A subsequent visit is any routine assessment in hospital following the hospital admission assessment. This code (C022) specifically applies to visits rendered during the first five weeks of a patient's hospital stay by a Dermatology specialist.
When to Use
- Use C022 for daily inpatient dermatology rounds during the first 35 days of a patient's hospital stay when you are acting as a consultant rather than the MRP.
- Use C022 when providing ongoing dermatological management for a patient admitted under another service, provided the visit occurs within the first 5 weeks of their admission date.
Common Pitfalls
- Billing C022 beyond day 35 of the patient's hospital stay; ensure you transition to C027 for weeks 6-13 to avoid automated rejections.
- Attempting to bill C022 on the same day as a consultation (e.g., C020) for the same patient, which will result in the subsequent visit being rejected.
- Failing to reset the 5-week clock when you are the second physician to see a patient upon referral; the date of your first assessment acts as the 'admission date' for your billing sequence.
Billing Tips
- If you are the Most Responsible Physician (MRP), prioritize using the C122, C123, or C124 series where applicable, and append E083 or E084 to your C022 claim to capture the MRP premium if you meet the remuneration criteria.
- Always verify the patient's actual hospital admission date to ensure you are in the correct time-based code bracket (C022, C027, or C029) before submitting your claim.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Hospital In-Patient Services (Non-Emergency)
Assessment
The service requires a direct physical encounter with the patient.
If, in the interest of the patient, the referring physician is asked to be present by the patient or the patient’s representative, but does not assist at the procedure, the attendance at surgery by the referring physician constitutes a hospital subsequent visit.
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