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C244
C244 – Specific re-assessment
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
C244 is a specific re-assessment rendered by a physician with the Otolaryngology (24) specialty for a non-emergency hospital in-patient. As per the definition in the General Preamble (page ), a specific re-assessment requires a full, relevant history and a physical examination of one or more systems. It is used for hospital in-patient services as per the 'C' prefix designation (pages , ).
When to Use
- Use C244 for the initial hospital admission assessment when you have already performed a pre-admission assessment for the same illness.
- Use C244 for a subsequent in-patient hospital visit that requires a full, relevant history and a focused physical examination of one or more systems, provided it does not meet the criteria for a consultation (C242).
- Use C244 when managing a patient admitted for a surgical procedure where you previously assessed them in the office for the same condition.
Common Pitfalls
- Billing C244 for routine daily hospital rounds, which should be billed as subsequent visits (C247) rather than a specific re-assessment.
- Exceeding the two-per-12-month limit for non-admission related specific re-assessments, which will trigger an automatic adjustment to a lower fee.
- Confusing C244 with a consultation (C242); C244 is for re-assessments, whereas C242 requires a formal request from another physician and a written report.
Billing Tips
- Ensure your documentation explicitly records a full, relevant history and a physical examination of at least one system to satisfy the General Preamble requirements for a 'specific' assessment.
- If the patient is in an ICU or CCU, remember to append the C101 premium to C244 to maximize the claim value, provided no other excluded team fees are claimed.
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