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C183

C183Medical specific assessment

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

A medical specific assessment rendered by a specialist in Neurology (18) to a non-emergency in-patient in an acute care hospital. As defined in : , this service is rendered by a specialist and requires a full history of the presenting complaint and detailed examination of the affected part(s), region(s), or system(s) needed to make a diagnosis, and/or exclude disease, and/or assess function. The 'C' prefix indicates the service is for non-emergency in-patient services in an acute care hospital as per : .

When to Use

  • Use C183 for a non-emergency, in-patient neurological assessment when a formal consultation (C185) is not requested by another physician.
  • Use C183 for a subsequent hospital visit that requires a full history and detailed neurological examination, exceeding the scope of a standard subsequent visit (C182).
  • Use C183 when the patient is admitted to an acute care hospital and you are performing a specific assessment that does not meet the criteria for a consultation.

Common Pitfalls

  • Billing C183 for patients in an emergency department or holding area; this code is strictly for acute care in-patients.
  • Exceeding the 4-visit annual limit (combined with C181) without realizing the Ministry will automatically reduce the fee for subsequent claims.
  • Confusing C183 with C185; remember that C185 is a consultation requiring a written request from another physician, whereas C183 is a specialist-initiated assessment.

Billing Tips

  • If you are seeing a patient in the ICU or CCU, ensure you append the C101 premium to your C183 claim to maximize the value of the encounter.
  • If you reach the 4-visit limit, ensure your documentation clearly differentiates the clinical necessity of the 5th visit to justify the lower-fee assessment if audited.
Provider Fee$0.00
Specialist Fee$82.40

Effective: June 1, 2025

Category

A. Consultations and Visits

Subcategory

CONSULTATIONS AND VISITS

Service Type

Assessment

Code Classes

Hospital and Institutional Consultations and Assessments, Assessments

The service must include a direct physical encounter with the patient, a full history of the presenting complaint, and a detailed examination of the affected part(s), region(s), or system(s). These details must be documented in the patient's medical record.

See to for non-emergency hospital in-patient services.

For emergency calls and other special visits to in-patients, use General Listings and Premiums when applicable - see to .

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