C134 – Medical specific re-assessment
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A medical specific re-assessment is an admission assessment rendered by an Internal Medicine specialist for the purpose of admitting a patient to an acute care hospital, when the physician has previously assessed the patient for the same presenting illness within 90 days of the admission assessment.
When to Use
- Use C134 when you are admitting a patient to hospital for a condition you evaluated in your office or clinic within the previous 90 days.
- Use C134 instead of C133 when the patient's current hospital admission is directly related to a clinical issue you previously assessed within the 90-day window.
Common Pitfalls
- Billing C134 for a patient you have not seen in the last 90 days, which should instead be billed as a C133 or C135.
- Attempting to bill C134 in conjunction with C133 or C135 for the same admission, which will trigger an automatic rejection.
- Failing to recognize that C134 is restricted to Internal Medicine specialists; billing this code as a different specialty will result in a claim error.
Billing Tips
- Always append the E082 premium to C134 if you are acting as the Most Responsible Physician (MRP) to increase the total claim value by 30%.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Hospital In-Patient (Non-Emergency)
Assessment
Must be the initial assessment rendered for the purpose of admitting a patient to hospital.
The physician must have previously assessed the patient for the same presenting illness within 90 days of the admission assessment.
Requires a direct physical encounter with the patient including history and physical examination ().
C134 is specifically for Internal Medicine (13). Other specialties use different codes for specific re-assessments (e.g., C034 for Vascular Surgery).
If the specialist assesses the patient in the Emergency Department (ED) and then admits them, the initial assessment in the ED constitutes the admission assessment.
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