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C243 – Specific assessment

OHIP Consultations and Visits Code — CONSULTATIONS AND VISITS · Schedule of Benefits

Levels of this visit

The C24x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

Assessments

  • C244 Specific re-assessment

    C244 is a specific re-assessment rendered by a physician with the Otolaryngology (24) specialty for a non-emergency hospital in-patient.

    $31.00
  • C243 Specific assessment(this code)

    C243 is a specific assessment for the specialty of Otolaryngology (specialty 24) rendered to a non-emergency in-patient of an acute care hospital, as indicated by the 'C' prefix…

    $44.75

Consultations

  • C246 Repeat consultation

    A repeat consultation is an additional consultation rendered by the same consultant for the same presenting problem, following care provided by another physician in the interval…

    $53.65
  • C245 Consultation

    A consultation is an assessment rendered to a non-emergency hospital in-patient following a written request from a referring physician, nurse practitioner, or dental surgeon.

    $92.70
C243 is a specific assessment for the specialty of Otolaryngology (specialty 24) rendered to a non-emergency in-patient of an acute care hospital, as indicated by the 'C' prefix (). As defined in the Schedule on page , a specific assessment requires a full history of the presenting complaint and a detailed examination of the affected part(s), region(s), or system(s) necessary to make a diagnosis, exclude disease, and/or assess function. This service includes all the specific elements of assessments outlined on page , which encompass: • A direct physical encounter with the patient, including history and examination. • Performing procedures during the same encounter unless separately payable. • Arranging for related assessments, procedures, or therapy. • Arranging for follow-up care. • Discussing findings and providing advice to the patient or their representative. • Monitoring the patient's condition as medically indicated.
All insured services must be documented in the patient's medical record to establish that the service was provided, was medically necessary, and is the service for which the account is submitted.
The medical record for a specific assessment must include a full history of the presenting complaint and a 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.

See General Preamble 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 General Preamble to .

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