C187 – Subsequent visit - sixth to thirteenth week inclusive
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A subsequent visit is a routine assessment for a hospital in-patient following the admission assessment. C187 is specifically for a Neurology specialist's visit rendered between the sixth and thirteenth week of a patient's hospitalization. The payment rules, as detailed in the General Preamble (), limit this service to a maximum of three visits per patient per week. Visits for acute intercurrent illness during this period may be claimed using C121.
When to Use
- Use C187 for routine neurology follow-up assessments for an inpatient between day 36 and day 91 of their continuous hospital stay.
- Use C187 when the patient is stable and does not require the intensive management associated with C121 for acute intercurrent illness.
Common Pitfalls
- Billing C187 beyond the 13-week threshold; once the patient exceeds 91 days, you must transition to the appropriate long-term subsequent visit code like C188.
- Exceeding the weekly limit of three visits; any claim for a fourth visit in a rolling seven-day period will be automatically rejected by the Ministry.
- Failing to account for the original admission date when a patient is transferred to your service, leading to incorrect code selection based on the transfer date rather than the admission date.
Billing Tips
- If you are the Most Responsible Physician (MRP) and meet the criteria, append E083 to C187 to capture the 30% premium, or E084 for weekend/holiday visits.
- If the patient is located in an ICU or CCU, ensure you add the C101 premium to your C187 claim to maximize the value of the visit.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Assessment
Hospital and Institutional Consultations and Assessments
sixth to thirteenth week inclusive (maximum 3 per patient per week) per visit
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.