C077 – Subsequent visit - sixth to thirteenth week inclusive
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A routine assessment in hospital (non-emergency hospital in-patient service) rendered to a patient between the sixth and thirteenth week of their hospital admission inclusive.
When to Use
- Use for routine daily or periodic hospital rounds for patients who have been admitted for 6 to 13 weeks inclusive.
- Use when transitioning from C072 once the patient crosses the 5-week threshold of their hospital stay.
- Use when providing routine follow-up care for a patient who has been transferred to your service, treating the transfer date as the new 'admission date' for the week count.
Common Pitfalls
- Billing more than 3 visits per week for C077; any visits beyond this limit for routine care are non-billable unless they meet the criteria for C121.
- Failing to switch to C079 once the patient exceeds the 13-week threshold, which will lead to claim rejections for exceeding the usage limits of C077.
- Attempting to bill special visit premiums (travel or person seen) alongside C077, as these are explicitly excluded for routine hospital rounds.
Billing Tips
- Always append E083 (or E084 on weekends/holidays) to C077 if you are the Most Responsible Physician to capture the 30-45% premium.
- If a patient develops an acute intercurrent illness requiring more than 3 visits per week, bill the additional visits as C121 rather than attempting to force them into C077.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Hospital In-Patient
Assessment
The service must be a routine assessment following the hospital admission assessment.
The visit must occur during the 6th to 13th week of the patient's hospitalization.
Subsequent visits are limited to one per patient per day for the first 5 weeks (C072), 3 per week for weeks 6-13 (C077), and 6 per month after 13 weeks (C079).
Special visit premiums (travel and person seen) are not eligible for routine subsequent visits during hospital rounds.
Age-based fee premiums do not apply to subsequent visits.
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