C442 – Subsequent visit - first five weeks
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A routine assessment in hospital following the hospital admission assessment, for a non-emergency in-patient. As per , a subsequent visit includes assessments for multidisciplinary care. If the referring physician is asked to be present at surgery but does not assist, the attendance constitutes a hospital subsequent visit.
When to Use
- Use C442 for routine daily assessments of an in-patient by a consulting physician who is not the Most Responsible Physician (MRP).
- Use C442 when a physician is requested to be present during a surgery but does not act as the surgical assistant, provided a physical assessment is performed.
- Use C442 for multidisciplinary care assessments performed on an in-patient after the initial admission assessment has been completed.
Common Pitfalls
- Billing C442 as the MRP instead of using the appropriate C122, C123, or C124 codes, which will lead to claim rejection or audit recovery.
- Attempting to bill C442 on the day of discharge, which is restricted; the discharge day must be billed using C124.
- Failing to account for the patient's original admission date when taking over care from another physician, which can lead to incorrect billing of subsequent visit tiers.
Billing Tips
- If you are the MRP, always append the E083 premium to your subsequent visit codes to receive the 30% fee increase, provided you meet the remuneration eligibility criteria.
- When working in an ICU or CCU setting, ensure you add the C101 premium to C442 if no other separate fee is claimed for that specific visit.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Assessment
Hospital and Institutional Consultations and Assessments
As with all insured services, the service must be documented in the patient's medical record, establishing that the service was provided, is the service for which the account is submitted, and was medically necessary. ()
The service must include the specific elements of an assessment as defined in the Schedule, including a direct physical encounter, history, and any medically indicated monitoring until the next insured service. ()
See General Preamble to for rules on Non-Emergency Hospital In-Patient Services.
For emergency calls and other special visits to in-patients, use General Listings ('A' prefix codes) and Premiums when applicable - see General Preamble to .
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.