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C137
C137 – Subsequent visit - sixth to thirteenth week inclusive
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A routine subsequent visit rendered to a hospital in-patient or a patient in a long-term care institution (chronic care or convalescent hospital) between the sixth and thirteenth week of their stay, inclusive.
When to Use
- Use C137 for routine follow-up assessments of an in-patient between day 36 and day 91 of their hospital stay, transitioning from C132 after the fifth week.
- Apply C137 when a referring physician attends a surgery as an observer without acting as a surgical assistant, provided the patient is within the 6-13 week window.
- Use C137 for patients in chronic care or convalescent facilities who do not qualify for W133 nursing home visit codes.
Common Pitfalls
- Billing C137 beyond the 13-week threshold; once the patient reaches the 14th week, you must switch to C139 to avoid automatic rejections.
- Claiming C137 on the day of discharge; you must use C124 or C126 for discharge dates instead of the routine subsequent visit code.
- Exceeding the maximum of 3 visits per week for C137; any additional visits required for acute intercurrent illness must be billed using C121.
Billing Tips
- Always append the E083 MRP premium to C137 if you are the Most Responsible Physician to maximize the claim value, provided you do not receive unadjusted hospital remuneration.
- Ensure your billing software tracks the 'admission date' accurately, as the 6-13 week window is calculated strictly from the date of admission to the facility.
Provider Fee$0.00
Specialist Fee$34.10
Effective: June 1, 2025
Category
A. Consultations and Visits
Subcategory
CONSULTATIONS AND VISITS
Service Type
Consultations and Visits
Code Classes
Assessment
The visit must be a routine assessment following the hospital admission assessment.
The patient must have been in the hospital or institution for at least 6 weeks but no more than 13 weeks.
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