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C049
C049 – Subsequent visit - after thirteenth week
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Subsequent visit - after thirteenth week (maximum 6 per patient per month) (per visit)
When to Use
- Use C049 for routine daily progress notes once the patient has surpassed 13 weeks of continuous hospitalization.
- Use C049 when managing chronic in-patients who have transitioned past the billing windows for C042 and C047.
Common Pitfalls
- Billing C049 for patients in palliative care beds, which requires specific palliative care codes instead.
- Exceeding the maximum of 6 visits per month, which will trigger automatic rejections from OHIP.
- Failing to switch to C121 when an acute intercurrent illness requires additional visits beyond the monthly limit of 6.
Billing Tips
- Always append E083 or E084 if you are the Most Responsible Physician (MRP) to maximize the value of the C049 encounter.
- Ensure your billing software tracks the patient's admission date accurately to trigger the automatic transition from C047 to C049 at the 14-week mark.
Provider Fee$0.00
Specialist Fee$31.00
Effective: June 1, 2025
Category
A. Consultations and Visits
Subcategory
CONSULTATIONS AND VISITS
Service Type
Hospital In-Patient
Code Classes
Assessment
Subsequent visits are calculated based on the actual admission date of the patient, even if transferred between physicians ().
If a physician assesses another physician's patient on an emergency basis, General Listings ('A' prefix) apply instead of C049 ().
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