C347 – Subsequent visit - sixth to thirteenth week inclusive
OHIP Surgical Procedures Code — RADIATION ONCOLOGY (34) · Schedule of Benefits
Subsequent visit for a patient under the care of a Radiation Oncologist. This service is for non-emergency hospital in-patients and is applicable from the sixth to the thirteenth week of admission, inclusive. Per , a subsequent visit is any routine assessment in hospital following the hospital admission assessment. It includes: - Attendance at surgery if the physician is asked to be present by the patient or their representative but does not assist. - Visits as part of multidisciplinary care when the complexity of the medical condition requires the services of several physicians in different disciplines, each physician's visit constitutes a subsequent visit.
When to Use
- Use for routine, non-emergency hospital follow-up visits for radiation oncology patients specifically between the 6th and 13th week of their hospital admission.
- Use when providing multidisciplinary care visits where the radiation oncologist is required to assess the patient as part of a complex care team during the 6th to 13th week window.
- Use for attendance at surgery when the radiation oncologist is requested to be present by the patient or representative but does not act as a surgical assistant.
Common Pitfalls
- Billing C347 based on the date of transfer to your service rather than the patient's original hospital admission date, which can lead to incorrect code selection.
- Failing to account for the 13-week limit; visits occurring after the 13th week must be billed using the appropriate long-term subsequent visit code (C349).
- Attempting to bill C347 for emergency assessments, which should instead be billed using the appropriate consultation or emergency visit codes.
Billing Tips
- If you are the Most Responsible Physician (MRP) and meet the remuneration criteria, ensure you append the E083 premium to maximize the value of the C347 visit.
- Always verify the patient's original admission date in the hospital chart to ensure the visit falls within the 6th to 13th-week range, as this dictates the correct subsequent visit code.
Effective: June 1, 2025
A. Consultations and Visits
RADIATION ONCOLOGY (34)
Assessment
Hospital and Institutional Consultations and Assessments
The medical record must document all constituent elements of the service, as required by the Health Insurance Act.
As an assessment, this service must include a direct physical encounter, history taking, physical examination, and other specific elements as defined in .
When a hospital in-patient is referred from one physician to another physician, the date the second physician assessed the patient for the first time is considered the 'admission date' for the purposes of determining the appropriate subsequent visit fee code.
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