C182 – Subsequent visit - first five weeks
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A subsequent visit is any routine assessment in a hospital following the hospital admission assessment. This service is for a non-emergency in-patient and applies to visits rendered during the first five weeks after admission. As an assessment, it includes all specific elements outlined in the Schedule of Benefits (), such as a direct physical encounter, history taking, physical examination, and discussion with the patient or their representative.
When to Use
- Use C182 for routine daily hospital visits during the first 35 days of an inpatient stay when you are not the Most Responsible Physician (MRP) or do not meet the criteria for MRP-specific codes like C122.
- Use C182 when providing a standard subsequent assessment for a patient transferred to your care, as the date of your first assessment resets the five-week clock for your specific billing cycle.
Common Pitfalls
- Billing C182 alongside a Special Visit Premium (SVP) will result in automatic rejection; you must use an 'A' prefix code if you are claiming an SVP for an emergency or urgent hospital visit.
- Attempting to bill C182 more than once per day for the same patient is a common error; subsequent visits are strictly limited to one per patient, per day.
- Confusing C182 with MRP-specific codes (C122, C123, C124) leads to audit recovery if you are not the designated MRP or if you fail to meet the specific documentation requirements for those higher-paying codes.
Billing Tips
- If you are the MRP, ensure you append the E083 or E084 premium to your subsequent visit claims to maximize the fee, provided you meet the criteria regarding hospital remuneration.
- For patients requiring visits beyond the standard frequency due to an acute intercurrent illness, use C121 instead of C182 to bypass weekly or monthly volume limits.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Assessment
Hospital and Institutional Consultations and Assessments
When a patient is referred from one physician to another, the first visit by the second physician marks the new 'admission date' for calculating which subsequent visit code to use.
Visits due to an acute intercurrent illness in excess of weekly or monthly limits should be claimed as C121.
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