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C023

C023Subsequent visits - Nursing home or home for the aged

OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits

A specific assessment rendered to a hospital in-patient by a dermatology specialist. This code is typically used for the initial admission assessment of a patient not seen by the specialist for the same condition within the last 90 days.

When to Use

  • Use C023 for the initial assessment of a patient newly admitted to an acute care hospital when you are not the Most Responsible Physician (MRP).
  • Use C023 when performing the primary admission assessment for a patient you have not seen for the same condition in the previous 90 days.

Common Pitfalls

  • Billing C023 when the patient was already assessed by you for the same presenting illness within the last 90 days, which requires C024 instead.
  • Confusing C023 with W023; C023 is strictly for acute care hospital settings, while W023 is reserved for nursing home or home for the aged visits.
  • Attempting to bill C023 in conjunction with a consultation code on the same day, which will result in an automatic rejection.

Billing Tips

  • If you are the Most Responsible Physician (MRP) for the admission, ensure you append the E082 premium to the C023 claim to capture the 30% fee increase.
Provider Fee$0.00
Specialist Fee$43.00

Effective: June 1, 2025

Category

A. Consultations and Visits

Subcategory

CONSULTATIONS AND VISITS

Service Type

Hospital In-Patient

Code Classes

Assessment

C023 is for Acute Care Hospital; W023 is for Nursing Home.

If the physician is not the MRP, the E082 premium cannot be billed.

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