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C072

C072Subsequent visit - first five weeks

OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits

A routine assessment in hospital following the hospital admission assessment, rendered to a patient during the first five weeks of their hospital stay.

When to Use

  • Use C072 for routine daily inpatient rounds occurring after the initial admission assessment and before the start of the sixth week of hospitalization.
  • Use C072 when a referring physician attends a surgery performed by another physician, provided they are not acting as the surgical assistant.
  • Use C072 for subsequent visits provided by a consultant who is not the Most Responsible Physician (MRP) during the first 35 days of the patient's stay.

Common Pitfalls

  • Billing C072 on the same day as C122 or C123, which are reserved specifically for the MRP and carry higher fees.
  • Continuing to bill C072 after the 35-day threshold, at which point you must transition to C077 for weeks 6 through 13.
  • Attempting to bill C072 for emergency assessments; these must be billed using the 'A' prefix equivalent (e.g., A072) to reflect the urgent nature of the service.

Billing Tips

  • Always append the E083 premium to C072 if you are the MRP and meet the remuneration requirements to increase the claim value.
  • Ensure the date of service matches the hospital chart entry exactly, as the 5-week limit is strictly calculated based on the admission date.

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