All codes
C037
C037 – Subsequent visit - sixth to thirteenth week inclusive
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
- sixth to thirteenth week inclusive (maximum 3 per patient per week) (per visit)
When to Use
- Use C037 for routine progress assessments of an admitted patient occurring between day 36 and day 91 of their hospital stay.
- Use this code for standard daily or periodic follow-ups when the patient does not meet the criteria for an intercurrent illness visit (C121) or concurrent care (C038).
Common Pitfalls
- Billing C037 beyond the 13th week of admission will trigger rejections; switch to C039 for any visits occurring from day 92 onwards.
- Exceeding the maximum of 3 visits per week will result in automatic claim rejections for the excess services.
- Failing to transition from C032 to C037 at the start of the 6th week is a common audit trigger for overpayment.
Billing Tips
- If you are the Most Responsible Physician (MRP), always append the E083 premium to C037 to capture the additional fee for MRP services.
- Ensure your billing software tracks the patient's admission date accurately to trigger the automatic switch from C032 to C037 on the 36th day.
Provider Fee$0.00
Specialist Fee$34.10
Effective: June 1, 2025
Category
A. Consultations and Visits
Subcategory
CONSULTATIONS AND VISITS
Service Type
Hospital In-Patient
Code Classes
Assessment
The service must be a routine assessment following the patient's admission to a hospital.
The service must be rendered during the period starting from the sixth week up to and including the thirteenth week of the hospital stay.
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