C384 – Consultation and Management for ACVS
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
C384 is a consultation and management service for Acute Coordinated Vascular Services (ACVS) rendered by a neurologist to a non-emergency hospital in-patient. As a 'C' prefix code, it is specifically for services provided in an acute care hospital for non-emergency in-patient services as outlined in the General Preamble (). The payment for this service is subject to the same conditions as billing code A384. All general requirements for consultations, including a written request from a referring practitioner, must be met as per .
When to Use
- Use C384 when providing an initial neurological consultation for an acute vascular event in a non-emergency hospital inpatient setting.
- Use this code specifically when the service is part of the Acute Coordinated Vascular Services (ACVS) pathway, ensuring it is distinct from standard A384 office-based consultations.
Common Pitfalls
- Failure to document the exact start and stop times of the service and the precise time of symptom onset will result in an automatic reduction to a lower assessment fee.
- Billing C384 for ongoing management of a patient for whom you have already performed a consultation for the same diagnosis is a violation of GP16 and will lead to rejections.
- Attempting to bill C384 on the same day as G521, G522, G523, or G391 without a distinct, unrelated diagnosis will trigger a billing conflict.
Billing Tips
- Ensure the written referral request is clearly identifiable in the hospital chart to satisfy GP16 requirements, as the absence of this documentation will cause the claim to be downgraded to a lesser assessment.
- Always verify that the patient's age-based premium is applied correctly to the base C384 fee, as these premiums are specifically eligible for this consultation code.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Consultation
Consultations, Hospital and Institutional Consultations and Assessments
A copy of the written request for the consultation, signed by the referring physician, nurse practitioner or dental surgeon must be kept in the consulting physician's medical record, except in the case of a consultation which occurs in a hospital, long-term care institution or multi-specialty clinic where common medical records are maintained. In such cases, the written request may be contained on the common medical record.
The request identifies the consultant by name, the referring physician, nurse practitioner or dental surgeon by name and billing number, and identifies the patient by name and health number.
The written request sets out the information relevant to the referral and specifies the service(s) required.
Consultation and Management for ACVS is only eligible for payment if start and stop times of the services and the time of onset of symptoms are recorded in the patient's permanent medical record.
Subject to the same conditions as A384.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.