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C089
C089 – Plastic Surgery - Consultation
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A routine assessment rendered in a hospital to an in-patient following the hospital admission assessment, provided after the patient has been hospitalized for more than 13 weeks.
When to Use
- Use C089 for routine follow-up assessments of a plastic surgery patient who has remained an in-patient for more than 13 consecutive weeks.
- Use C089 when the patient is stable and the visit does not meet the criteria for an acute intercurrent illness requiring C121.
Common Pitfalls
- Billing C089 before the 92nd day (13 weeks) of hospitalization will result in rejection; use C087 for visits occurring between the 6th and 13th week.
- Exceeding the limit of 6 visits per month will trigger automatic rejections for the 7th visit onwards.
- Attempting to bill C089 for patients in designated palliative care beds is prohibited and will be flagged during audit.
Billing Tips
- If you are the Most Responsible Physician (MRP), ensure you append E083 to C089 to receive the 30% premium, provided you meet the specific MRP eligibility criteria.
Provider Fee$0.00
Specialist Fee$31.00
Effective: June 1, 2025
Category
A. Consultations and Visits
Subcategory
CONSULTATIONS AND VISITS
Service Type
Hospital In-Patient
Code Classes
Assessment
Service must be rendered after the 13th week of hospitalization.
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