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C110

C110First person seen - Non-elective diagnostic services

OHIP Surgical Procedures Code — OTHER PREMIUMS · Schedule of Benefits

The phrase 'during the night (00:00h - 07:00h)' should be corrected to 'during Saturday, Sunday, and Holidays (07:00h - 24:00h)'.

When to Use

  • Use C110 when you are called into the hospital on a weekend or holiday to perform an urgent diagnostic service, such as an emergency ultrasound or procedure, that cannot wait until the next business day.
  • Apply this code when the patient's acute clinical status requires an immediate diagnostic interpretation that directly alters the current management plan during a weekend or holiday period.

Common Pitfalls

  • Billing C110 for services rendered via PACS or remote access is a common audit trigger, as the premium strictly requires physical attendance at the hospital facility.
  • Attempting to claim C110 alongside emergency department 'H' prefix codes will result in an automatic rejection due to billing interaction restrictions.
  • Submitting C110 for patients seen during routine hospital rounds or elective admissions is ineligible, as the service must be non-elective and urgent.

Billing Tips

  • Ensure the exact time of the special visit is clearly noted in the patient's chart, as this is a mandatory documentation requirement for audit compliance.
  • Remember that C110 is limited to one premium per patient per physician per special visit, even if multiple diagnostic services are performed during that same encounter.
Provider Fee$0.00
Specialist Fee$100.00

Effective: April 1, 2025

Category

GP. General Preamble

Subcategory

OTHER PREMIUMS

Service Type

Premium

Code Classes

Other Premiums (including After Hours Procedure Premiums)

The time at which the special visit takes place must be documented on the medical record.

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