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C139

C139Subsequent visit - after thirteenth week

OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits

A routine subsequent hospital in-patient visit rendered by an Internal Medicine specialist to a patient who has been hospitalized for more than thirteen weeks.

When to Use

  • Use for routine follow-up assessments of an Internal Medicine patient who has surpassed the 13-week threshold of their current hospital admission.
  • Use when attending a surgery as an observer in the patient's interest, provided no other surgical assist or procedure code is claimed for that encounter.
  • Use as the base code for the MRP premium (E083/E084) when managing long-term stable in-patients beyond the 13-week mark.

Common Pitfalls

  • Billing C139 for patients in designated palliative care beds, which requires the use of C982 instead.
  • Exceeding the maximum limit of 6 visits per month, which often triggers automated rejections unless an intercurrent illness justifies using C121.
  • Failing to account for the original hospital admission date when calculating the 13-week threshold, especially after a transfer between services or facilities.

Billing Tips

  • Always append the E083 MRP premium to C139 if you are the Most Responsible Physician to maximize the value of these long-term visits.
  • If a patient develops an acute intercurrent illness requiring more than 6 visits in a month, bill the additional visits as C121 rather than attempting to force them into C139.
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 (Non-Emergency)

Code Classes

Assessment

The service must be rendered after the patient has been in the hospital for more than 13 weeks.

The visit must be a routine assessment following the hospital admission assessment.

If the physician is present at a surgery in the interest of the patient but does not assist, the service may be billed as a subsequent visit (C139).

For patients in Chronic Care or Convalescent hospitals, use 'W' prefix codes (e.g., W131, W132) instead of C139.

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