C047 – Subsequent visit - sixth to thirteenth week inclusive
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A routine assessment in hospital or a long-term care institution following the hospital admission assessment, rendered between the sixth and thirteenth week of the patient's stay (inclusive).
When to Use
- Use C047 for routine follow-up assessments of an admitted patient occurring between the 6th and 13th week of their hospital or LTC stay.
- Use C047 when the patient has transitioned past the initial 5-week period covered by C042, but has not yet reached the 14th week threshold for C049.
Common Pitfalls
- Exceeding the maximum of 3 visits per week for routine care, which will trigger automatic rejections; use C121 only if an acute intercurrent illness necessitates additional visits.
- Billing C047 for patients in designated palliative care beds, which is prohibited; these services must be billed using specific palliative care codes.
- Failing to reset the 'admission date' clock when a patient is transferred to a new physician, leading to incorrect code selection between C042, C047, and C049.
Billing Tips
- If you are the Most Responsible Physician (MRP), always append the E083 premium to your C047 claim to increase the fee by 30%, provided you do not receive other hospital-based remuneration for these services.
- Ensure your documentation clearly reflects the patient's current week of stay to justify the transition from C042 to C047 and eventually to C049.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Subsequent Visit
Assessment
The service must be a routine assessment following the admission assessment.
The physician must be in the hospital or LTC facility to assess the patient.
Non-Emergency Long-Term Care In-Patient Services includes Chronic Care Hospitals, Convalescent Hospitals, Nursing Homes, and designated chronic/convalescent beds in other facilities.
If the physician is already in the hospital and assesses their own patient, it constitutes a subsequent visit.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.