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C071
C071 – Complex medical specific re-assessment
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A complex medical specific re-assessment is a re-assessment of a patient because of the complexity, obscurity, or seriousness of the patient’s condition and includes all the requirements of a medical specific re-assessment. It is rendered by a specialist in Geriatrics for an in-patient in a non-emergency hospital setting.
When to Use
- Use C071 for an inpatient geriatric patient (65+) requiring a comprehensive re-evaluation of a complex, multi-system condition that exceeds the scope of a standard C074 re-assessment.
- Use C071 for patients under 65 specifically when the clinical focus is the assessment of dementia, provided the complexity warrants the higher fee over a standard assessment.
Common Pitfalls
- Billing C071 more than 4 times in a 12-month period per patient, which triggers an automatic adjustment to a lower assessment fee as it shares the limit with C073.
- Failing to document and send a formal written report to the primary care physician, which results in the claim being downgraded to a lesser assessment fee upon audit.
Billing Tips
- Ensure the clinical note clearly justifies the 'complexity or obscurity' of the condition to support the use of C071 over the lower-valued C074 re-assessment code.
Provider Fee$0.00
Specialist Fee$91.90
Effective: June 1, 2025
Category
A. Consultations and Visits
Subcategory
CONSULTATIONS AND VISITS
Service Type
In-patient
Code Classes
Assessment
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