All codes
C159
C159 – Subsequent visit - after thirteenth week (maximum 6 per patient per month)
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Subsequent visit - after thirteenth week (maximum 6 per patient per month) (per visit)
When to Use
- Use C159 for routine daily follow-up care of an endocrinology or metabolism in-patient who has exceeded 91 days (13 weeks) of continuous hospitalization.
- Use C159 when the patient's condition is stable or following the established care plan, distinguishing it from C121 which is reserved for acute, intercurrent illnesses requiring additional visits.
Common Pitfalls
- Billing C159 beyond the 6-visit monthly limit will result in automatic rejections; use C121 for medically necessary visits exceeding this cap if a new or complicating illness arises.
- Failing to transition from C157 to C159 immediately upon the start of the 14th week of hospitalization is a common audit trigger for incorrect code selection.
Billing Tips
- Always append the E083 MRP premium to C159 if you are the Most Responsible Physician and meet the remuneration requirements to maximize the value of these long-term care visits.
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
Code Classes
Assessment
The service must be rendered to a hospital in-patient.
The patient must have been hospitalized for more than thirteen weeks.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.