C024 – Specific re-assessment
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A specific re-assessment is a service rendered by a specialist in a hospital in-patient setting (non-emergency) that requires a full, relevant history and physical examination of one or more systems. It is typically used as an admission assessment when the physician has previously assessed the patient for the same presenting illness within 90 days.
When to Use
- Use C024 when admitting a patient to hospital for a condition you have already evaluated in your office or clinic within the preceding 90 days.
- Use C024 as the admission assessment code when the patient is re-admitted for the same presenting illness within 90 days of your previous assessment.
Common Pitfalls
- Billing C024 for an admission assessment when you have not seen the patient for that specific condition in the last 90 days; this should be billed as C023 or C025.
- Attempting to bill a subsequent visit (C122) on the same calendar day as the C024 admission assessment, which will result in an automatic rejection.
- Billing C024 when assuming care of a patient transferred from another physician within the same hospital, as this is not a valid trigger for an admission assessment code.
Billing Tips
- Ensure your documentation explicitly references the date of your previous assessment for the same condition to justify the use of C024 over the higher-valued C023 or C025.
- Verify that the admission is for the same presenting illness, as a new, unrelated diagnosis would require a new consultation (C025) or specific assessment (C023) rather than a re-assessment.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Hospital In-patient
Assessment
C024 is the appropriate code for an admission assessment if the physician has seen the patient for the same illness within the previous 90 days.
If the physician is not the admitting physician but is seeing the patient in the Emergency or OPD, use General Listings (A-prefix) instead of C-prefix codes.
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