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C067
C067 – Subsequent visit - sixth to thirteenth week inclusive
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Subsequent visit - sixth to thirteenth week inclusive (maximum 3 per patient per week) (per visit)
When to Use
- Use C067 for routine daily or periodic assessments of an in-patient who has been hospitalized for between 6 and 13 weeks inclusive.
- Use C067 when you are requested to be present at a surgery for a patient under your care but do not perform the surgical assist, as this attendance qualifies as a subsequent visit.
Common Pitfalls
- Billing C067 more than 3 times in a rolling 7-day period will trigger an automatic rejection; use C121 if an acute intercurrent illness necessitates additional visits beyond this limit.
- Failing to reset the 'week count' when taking over care from another physician; the 6-13 week window for C067 is calculated based on the date you first assessed the patient, not the patient's total hospital admission duration.
- Attempting to claim special visit premiums (travel or person seen) with C067, which are strictly prohibited for routine in-patient subsequent visits.
Billing Tips
- Always append the E083 premium if you are the Most Responsible Physician (MRP) to increase the C067 fee by 30%.
- If the patient is located in an ICU or CCU, ensure you add the C101 premium to the C067 claim to capture the additional $9.10 fee.
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
Routine assessment in hospital following the hospital admission assessment.
If the physician is asked to be present at surgery but does not assist, the attendance constitutes a hospital subsequent visit.
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