All codes
C073
C073 – Subsequent visit - first 2 per month
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A medical specific assessment rendered by a Geriatrics specialist to a hospital in-patient, requiring a full history of the presenting complaint and a detailed examination of the affected systems to make a diagnosis or assess function.
When to Use
- Use C073 for the first two subsequent hospital visits per month for geriatric patients requiring a comprehensive assessment of function or diagnosis.
- Use C073 for patients under 65 specifically when the clinical focus is a formal dementia assessment, as this bypasses the standard age restriction.
Common Pitfalls
- Billing C073 for patients in a Long-Term Care facility; ensure you use W073 instead, as C073 is strictly for hospital in-patients.
- Exceeding the combined limit of 4 visits when billing in conjunction with C071, which will trigger an automatic rejection.
- Failing to apply the E078 premium when the visit meets chronic disease management criteria, resulting in a missed 50% fee increase.
Billing Tips
- Always append the E078 chronic disease assessment premium to C073 when managing eligible chronic conditions to maximize the specialist fee.
Provider Fee$0.00
Specialist Fee$90.45
Effective: June 1, 2025
Category
A. Consultations and Visits
Subcategory
CONSULTATIONS AND VISITS
Service Type
Non-Emergency Hospital In-Patient Services
Code Classes
Assessment
Subject to the same conditions as A073
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