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C126
C126 – Subsequent visit - day of discharge, medically complex patient
OHIP Surgical Procedures Code · Schedule of Benefits
A subsequent visit rendered by the Most Responsible Physician (MRP) on the day of discharge for a medically complex patient who has been hospitalized for at least 7 days and has multiple contributing diagnoses.
When to Use
- Use C126 for medically complex patients hospitalized for at least 7 days who require a minimum of 45 minutes of direct physician time to coordinate discharge, reconcile complex medication regimens, and finalize the discharge summary.
- Choose C126 over C124 when the complexity of the discharge process necessitates extensive documentation and multi-disciplinary coordination that exceeds the scope of a standard discharge visit.
Common Pitfalls
- Billing C126 without documenting the 45-minute time requirement, which triggers an automatic adjustment to the lower-paying C124 during audit or claims processing.
- Attempting to bill C122 or C123 on the same day as C126, which will result in an automatic rejection of the subsequent visit codes.
- Failing to complete the discharge summary within the mandatory 48-hour window, rendering the C126 claim non-compliant with the Schedule of Benefits.
Billing Tips
- Always append the E083 premium to C126 to maximize the claim value, provided you meet the criteria for MRP subsequent visit premiums.
- Ensure the discharge summary explicitly lists the reason for admission, procedures, diagnosis, and discharge medications to satisfy the specific documentation requirements of C126.
Provider Fee$95.10
Effective: April 1, 2026
Service Type
Hospital In-Patient
Code Classes
Assessment
C124Subsequent visit by the MRP – day of dischargeA13: Terms and conditions for MRP visitsC122Subsequent visit by the MRP – day following the hospital admission assessmentC123Subsequent visit by the MRP – second day following the hospital admission assessmentC142First subsequent visit by the MRP following transfer from an Intensive Care AreaC143Second subsequent visit by the MRP following transfer from an Intensive Care AreaE083Subsequent visit by the MRP premiumE084Saturday, Sunday or Holiday subsequent visit by the MRP premium
C126 is a qualifying service for the 17% Hospitalist Premium ().
In case of conflicting claims, the physician to whom the patient is rostered may receive payment.
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