All codes
C083
C083 – Specific assessment
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A specific assessment is a service rendered by a specialist (Plastic Surgery) for a hospital in-patient, requiring a full history of the presenting complaint and a detailed examination of the affected part(s), region(s), or system(s) needed to make a diagnosis, and/or exclude disease, and/or assess function.
When to Use
- Use C083 for a new, distinct in-patient consultation for a plastic surgery issue that has not been previously assessed by you within the last 12 months.
- Use C083 when evaluating a hospitalized patient for a new surgical concern that is unrelated to their current admission diagnosis or any prior outpatient assessment.
Common Pitfalls
- Billing C083 for an admission assessment when you have already seen the patient in your office for the same surgical issue; this must be billed as C084.
- Attempting to bill C083 more than once per year for the same diagnosis, which will trigger an automatic adjustment to the lower-valued C084.
- Confusing C083 with C085; C083 is a specific assessment, whereas C085 is reserved for a formal consultation requested by another physician.
Billing Tips
- If you have seen the patient in the office for the same condition within the last 12 months, bill C084 instead of C083 to avoid rejection or manual adjustment.
- Ensure your documentation clearly distinguishes the new diagnosis from any previous encounters to justify the second annual C083 if you are billing for two separate, unrelated conditions.
Provider Fee$0.00
Specialist Fee$46.80
Effective: June 1, 2025
Category
A. Consultations and Visits
Subcategory
CONSULTATIONS AND VISITS
Service Type
Hospital In-Patient Services
Code Classes
Assessment
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