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C119
C119 – Subsequent visit - after thirteenth week
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Subsequent visit - after thirteenth week (maximum 6 per patient per month) (per visit)
When to Use
- Use C119 for routine daily management of a Critical Care patient who has remained in the hospital beyond the 13-week threshold.
- Use C119 when performing a standard follow-up assessment on a patient transferred to your care, provided the transfer date has exceeded 13 weeks.
Common Pitfalls
- Billing C119 beyond the 6-visit monthly limit; any visits required for acute intercurrent illness beyond this limit must be billed as C121.
- Attempting to bill C119 on the same day as a discharge code like C124 or C126, which will result in an automatic rejection.
- Failing to reset the 13-week clock when a patient is transferred to your care; the 'admission date' for the new physician is the date of the first assessment.
Billing Tips
- Always append E083 or E084 to C119 if you are the Most Responsible Physician (MRP) to capture the additional premium, provided you meet the remuneration criteria.
- Ensure your documentation clearly reflects the patient's status as a long-stay inpatient to justify the use of the post-13-week code over C112 or C117.
Provider Fee$0.00
Specialist Fee$34.10
Effective: June 1, 2025
Category
A. Consultations and Visits
Subcategory
CONSULTATIONS AND VISITS
Service Type
Hospital In-patient
Code Classes
Assessment
See General Preamble to for comprehensive terms and conditions regarding hospital in-patient services.
Special visit premiums (travel/time) are not eligible for payment for routine hospital visits like C119.
For emergency calls to in-patients, use General Listings ('A' prefix) and applicable premiums.
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