C318 – Concurrent care - per visit
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Concurrent care is any routine assessment rendered in hospital by the consultant following the consultant's first major assessment of the patient when the family physician remains the most responsible physician but the latter requests continued directive care by the consultant. See for full details.
When to Use
- Use C318 when you are the consultant providing ongoing, non-emergency management for a patient whose primary care remains under the Most Responsible Physician (MRP).
- Use this code for routine follow-up visits in hospital when the patient does not meet the criteria for C315 (Supportive Care) or C316 (Chronic Care) and you are not the MRP.
Common Pitfalls
- Billing C318 when you are actually the MRP; if you are the primary provider managing the patient's hospital stay, you must use the appropriate subsequent visit codes (e.g., C122).
- Submitting C318 for visits that occur on the same day as a consultation (C002/C003); concurrent care is only applicable for visits following the initial consultation.
- Exceeding the weekly frequency limits for concurrent care, which will trigger automatic rejections or audit inquiries regarding the necessity of continued specialist involvement.
Billing Tips
- Ensure the referring physician's name and billing number are clearly linked to the claim to validate the 'requested directive care' requirement.
- You can append the C101 ICU/CCU premium to C318 if you are providing concurrent care to a patient specifically located within those units.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Assessment
Hospital and Institutional Consultations and Assessments
The 'C' prefix indicates a non-emergency hospital in-patient service.
For emergency calls and other special visits to in-patients, use General Listings ('A' prefix codes) and Premiums when applicable. See to .
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