All codes
C039
C039 – Subsequent visit - after thirteenth week
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A routine assessment in hospital following the hospital admission assessment, rendered by a General Surgeon (specialty 03) to an acute care hospital in-patient after the thirteenth week of hospitalization.
When to Use
- Use C039 for routine daily rounds for a surgical patient who has remained in an acute care hospital for more than 13 weeks.
- Use C039 when you are requested to be present at a surgery but do not perform the procedure or assist, provided the patient has exceeded the 13-week threshold.
Common Pitfalls
- Billing C039 before the 92nd day (13 weeks) of hospitalization, which will result in a rejection or audit recovery; use C032 or C037 for earlier timeframes.
- Attempting to bill C039 on the same day as a discharge visit (C124 or C126) or a consultation, which are mutually exclusive billing events.
- Exceeding the maximum of 6 visits per patient per month, which is a hard limit for this specific code.
Billing Tips
- If you are the Most Responsible Physician (MRP) and meet the criteria, ensure you append the E083 or E084 premium to maximize the value of the C039 encounter.
- Remember that the 13-week clock is based on the actual hospital admission date, not the date you were first involved in the patient's care.
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
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