C202 – Subsequent visit - first five weeks
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A subsequent visit is any routine assessment rendered in a hospital following the hospital admission assessment. This specific code applies to visits by a specialist in Obstetrics and Gynaecology during the first five weeks of the patient's hospital stay. As an assessment, this service includes the specific elements of assessments as defined in (e.g., history taking, physical examination, arranging related care) and the common elements of all insured services as defined in and . It is limited to one visit per patient per day. For visits after the first five weeks, see C207 and C209.
When to Use
- Use C202 for routine daily hospital visits by an OB/GYN specialist during the first 35 days of an inpatient stay when you are not the Most Responsible Physician (MRP).
- Use C202 when providing follow-up care for a patient admitted under another service, such as internal medicine or general surgery, within the initial five-week window.
Common Pitfalls
- Billing C202 as the MRP; if you are the MRP, you must use C122, C123, or C124 to ensure appropriate compensation and eligibility for MRP-specific premiums.
- Attempting to bill a Special Visit Premium (e.g., K962) with C202; hospital subsequent visits are not eligible for these premiums, and non-elective urgent visits should be billed using an 'A' prefix code instead.
- Continuing to bill C202 beyond the 35-day limit; once the patient exceeds five weeks of hospitalization, you must transition to C207 or C209.
Billing Tips
- If you are the MRP, ensure you append the E083 premium to your subsequent visit code to receive the 30% fee increase, provided you do not receive unadjusted hospital remuneration.
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