C123 – Second day following the hospital assessment
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Payable to the physician identified as the patient’s MRP for rendering a subsequent visit on the second day following the hospital admission assessment.
When to Use
- Use C123 specifically for the MRP visit occurring exactly 48 hours after the initial admission assessment (C002 or equivalent).
- Use C123 instead of a standard subsequent visit (C007) to capture the higher fee associated with the second day of the inpatient stay.
Common Pitfalls
- Billing C123 when the patient is discharged on the same day, which triggers a rejection due to the restriction against C124 and C126.
- Attempting to bill C123 for multiple days; it is strictly limited to a maximum of one occurrence per hospital admission.
- Submitting C123 alongside C143, as these codes are mutually exclusive for the same patient during a single admission.
Billing Tips
- Always append the appropriate MRP premium (E083 or E084) to C123 to maximize the value of this specific visit.
- Ensure your billing software correctly sequences the admission date so that the 'second day' calculation aligns with the Ministry's automated validation.
Effective: April 1, 2026
A. Consultations and Visits
CONSULTATIONS AND VISITS
Hospital In-patient
Assessment
Must be rendered on the second day following the hospital admission assessment.
When a patient is transferred to another physician within the same hospital, C123 is only payable to the physician who was the MRP for the majority of the day.
When a patient is transferred to another physician at a different hospital, the day of transfer is deemed the day of admission for the receiving hospital.
C123 is a 'Qualifying service' for determining eligibility for MRP premiums in a qualifying year.
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