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C418
C418 – Concurrent care
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. As this is an assessment, it includes the specific elements of assessments outlined on page .
When to Use
- Use C418 when you have completed a formal consultation (C003/C004) and the MRP requests you continue to provide directive management for a specific condition while they remain the primary physician.
- Use C418 for ongoing daily or periodic hospital visits where you are actively directing care, as opposed to C121 (Supportive Care) which is used for non-directive, monitoring-only visits.
Common Pitfalls
- Billing C418 when the patient has been transferred to your service, making you the MRP; in this case, you must bill subsequent hospital visits (C002) instead.
- Exceeding the weekly frequency limits of 4 claims in the first week or 2 claims per week thereafter, which will trigger automatic rejections.
- Failing to document the specific request from the MRP for continued directive care, which is a mandatory requirement for audit compliance under GP48.
Billing Tips
- If the patient is located in an ICU or CCU, ensure you append the C101 premium to your C418 claim to maximize the value of the visit.
- Ensure your documentation clearly distinguishes your 'directive' role from 'supportive' care to avoid downgrades to C121 during an audit.
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