C107 – Additional person(s) seen
OHIP Surgical Procedures Code — OTHER PREMIUMS · Schedule of Benefits
A special visit premium payable for each additional patient seen during a non-elective special visit to a hospital for diagnostic services rendered on Saturdays, Sundays, or Holidays between 07:00 and 24:00.
When to Use
- Use C107 when you are called into the hospital on a weekend or holiday to perform a second or subsequent urgent diagnostic service after the first patient has already been billed with C110.
- Apply this code when you are already physically present at the hospital for an urgent diagnostic request and are subsequently asked to evaluate an additional acute care patient.
Common Pitfalls
- Billing C107 for remote interpretations performed via PACS from home, which is strictly prohibited as the service must occur at the hospital.
- Attempting to bill C107 for routine weekend rounds or elective diagnostic procedures, which do not meet the 'non-elective' requirement for special visit premiums.
- Submitting C107 for the first patient seen during the visit, which should instead be billed using the primary premium code C110.
Billing Tips
- Always pair C107 with the C104 travel premium if you were required to travel to the hospital specifically to attend to these patients.
- Ensure the diagnostic service fee is billed alongside C107, as the premium is intended to supplement the professional fee for the urgent interpretation or procedure.
Effective: April 1, 2025
GP. General Preamble
OTHER PREMIUMS
Diagnostic Services
Premium
The request for interpretation or service must relate to a patient’s condition requiring urgent interpretation that affects the patient’s management.
The visit must meet the definition of a 'Special Visit' (initiated by a patient or on behalf of a patient for a non-elective service).
Time period: Saturdays, Sundays, and Holidays (07:00-24:00).
Fee: $102.80.
This premium is payable in addition to the appropriate diagnostic radiology or nuclear medicine consultation, interpretation, or procedural fee.
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