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C092
C092 – Subsequent visit - first five weeks
OHIP Surgical Procedures Code — CARDIAC SURGERY (09) · Schedule of Benefits
A routine assessment in hospital following the hospital admission assessment, rendered during the first five weeks of the patient's stay.
When to Use
- Use C092 for routine daily rounds for a cardiac surgery patient during the first 35 days of their hospital stay.
- Use C092 when you are a consulting surgeon attending a patient in the interest of the patient at the request of the family, even if you are not the MRP and not assisting in surgery.
- Use C092 for the first assessment by a physician who has accepted a referral for an inpatient, as the referral date resets the 'admission date' clock for that specific physician.
Common Pitfalls
- Billing C092 on the day of discharge instead of the required C124, which will result in a rejection or audit recovery.
- Billing C092 on the day after admission instead of the required C122, or the second day after admission instead of C123.
- Attempting to bill C092 alongside Special Visit Premiums; C092 is strictly for routine care and is ineligible for travel or time-based premiums.
Billing Tips
- If you are the MRP, always append the E083 premium to your C092 claim to capture the 30% fee increase, provided you meet the remuneration criteria.
- Track the patient's stay duration carefully, as you must switch to C097 once the patient crosses the 5-week threshold to avoid claim rejections.
Provider Fee$0.00
Specialist Fee$31.00
Effective: June 1, 2025
Category
A. Consultations and Visits
Subcategory
CARDIAC SURGERY (09)
Service Type
Hospital In-Patient
Code Classes
Assessment
Must be a routine assessment following the hospital admission assessment.
For emergency calls or special visits to in-patients, use General Listings (A-prefix codes) and Premiums when applicable.
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