C249 – Subsequent visit - after thirteenth week
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A subsequent visit is any routine assessment in hospital by a physician in Otolaryngology (24) following the hospital admission assessment. C249 is specifically for visits rendered after the thirteenth week of the patient's hospitalization. According to (), subsequent visits include routine care for hospitalized patients, attendance at surgery by a referring physician (when not assisting), and care for patients in a multidisciplinary setting.
When to Use
- Use C249 for routine inpatient Otolaryngology assessments occurring on or after the 92nd day of the patient's continuous hospital stay.
- Apply this code for ongoing multidisciplinary care or routine follow-ups once the patient has exceeded the 13-week threshold, replacing the earlier C242 or C247 codes.
Common Pitfalls
- Billing C249 more than 6 times per calendar month will trigger automatic rejections, as the limit is patient-specific regardless of the number of physicians involved.
- Failing to account for the original admission date when inheriting a patient via transfer leads to incorrect code selection, as the 13-week clock does not reset upon transfer.
Billing Tips
- Always append the C101 premium when the C249 visit occurs within an ICU or CCU setting to maximize the claim value, provided no other excluded team-based fees are claimed.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Assessment
Hospital and Institutional Consultations and Assessments
After thirteenth week (maximum 6 per patient per month) per visit.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.