C232 – Subsequent visit - first five weeks
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A subsequent visit for a non-emergency hospital in-patient rendered by an ophthalmologist during the first five weeks of admission. According to the Schedule, a subsequent visit is any routine assessment in hospital following the hospital admission assessment. In addition to the common elements as defined in -, this service includes the specific elements of assessments as defined in , such as a direct physical encounter, history taking, physical examination, and discussion with the patient. It is limited to one per patient, per day.
When to Use
- Use for routine daily inpatient assessments by an ophthalmologist during the first 35 days of admission when you are not the Most Responsible Physician (MRP).
- Use as the MRP for routine daily assessments that do not fall on the specific days covered by C122 (day after admission), C123 (second day after admission), or C124 (day of discharge).
Common Pitfalls
- Billing C232 on the same day as C122, C123, or C124 will result in a rejection or adjustment, as these are mutually exclusive for the MRP.
- Attempting to bill C232 beyond the 35-day limit; once the five-week threshold is passed, subsequent visits for acute intercurrent illness must be billed as C121.
- Failing to recognize that C232 is restricted to one per patient per day; multiple visits on the same day are not payable under this code.
Billing Tips
- If you are the MRP and meet the remuneration criteria, always append the E083 premium to C232 to receive a 30% increase on the base fee.
- If the patient is located in an ICU or CCU, ensure you add the C101 premium to the C232 claim to capture the additional $9.10 fee.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Assessment
Hospital and Institutional Consultations and Assessments
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 General Preamble to .
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