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C349
C349 – Subsequent visit - after thirteenth week (maximum 6 per patient per month)
OHIP Surgical Procedures Code — RADIATION ONCOLOGY (34) · Schedule of Benefits
A subsequent visit by a specialist in Radiation Oncology (34) for a non-emergency hospital in-patient. This visit occurs after the thirteenth week of admission. A subsequent visit is any routine assessment in a hospital following the hospital admission assessment. This includes attendance at surgery if requested by the patient or their representative (when the physician does not assist), and visits for multidisciplinary care where several physicians in different disciplines are required for the patient's condition. See for full details on subsequent visits.
When to Use
- Use for routine follow-up assessments of a Radiation Oncology patient who has remained hospitalized beyond the 13-week threshold.
- Use when participating in multidisciplinary care rounds for a long-term inpatient where you are not the primary attending but are providing specialist input.
- Use for routine hospital visits after the patient has exhausted the frequency limits allowed under C347.
Common Pitfalls
- Billing C349 more than 6 times per calendar month will trigger automatic rejections; use C121 if an acute intercurrent illness requires additional visits beyond this limit.
- Failing to account for the original hospital admission date when calculating the 13-week threshold, even if you were not the physician who initially admitted the patient.
- Attempting to bill C349 on the same day as C121; these are mutually exclusive, and C121 should be used for acute changes in status.
Billing Tips
- If you are the Most Responsible Physician (MRP) and meet the remuneration criteria, always append E083 to C349 for a 30% premium, or E084 for a 45% premium on weekends and holidays.
- Ensure your clinical notes clearly distinguish between routine follow-up (C349) and management of an acute intercurrent illness (C121) to justify the billing choice during an audit.
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