All codes
C247
C247 – Subsequent visit - sixth to thirteenth week inclusive
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A routine in-hospital subsequent visit by a physician specializing in Otolaryngology (24) for a non-emergency in-patient, following the initial admission assessment. This service is for visits occurring from the sixth to the thirteenth week of hospitalization, inclusive. As per , a subsequent visit is any routine assessment in hospital following the hospital admission assessment. The timing for eligibility is calculated from the patient's original admission date. Visits in excess of three per week are not eligible for payment.
When to Use
- Use C247 for routine, non-emergency follow-up visits for Otolaryngology inpatients occurring between day 36 and day 91 of their original hospital admission.
- Use this code when the patient has already exceeded the initial 5-week window covered by C242 and C248, but has not yet reached the long-term care threshold of C249.
Common Pitfalls
- Billing more than three C247 visits in a rolling seven-day period will trigger an automatic rejection or recovery by OHIP.
- Failing to use the original hospital admission date to calculate the 6-13 week window often leads to incorrect code selection, as the clock does not reset upon transfer between physicians.
Billing Tips
- If you are the Most Responsible Physician (MRP), always append E083 for weekday visits or E084 for weekend/holiday visits to increase the base fee by 30% or 45% respectively.
- If the patient is located in an ICU or CCU, ensure you add the C101 premium to the C247 claim to capture the additional $9.10 fee.
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