C449 – Subsequent visit - after thirteenth week
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A subsequent visit is a routine assessment in hospital following the hospital admission assessment, as defined in . This specific code, C449, is for subsequent visits rendered by a physician in the Medical Oncology specialty to an in-patient in an acute care hospital. This service is applicable for visits occurring after the thirteenth week following the patient's admission date. The service includes the specific elements of an assessment as outlined on .
When to Use
- Use C449 for routine follow-up assessments of an oncology inpatient occurring strictly after the 13th week of their continuous hospital admission.
- Use this code for ongoing care when the patient remains in an acute care setting long-term, distinguishing it from earlier subsequent visit codes like C442 or C447.
Common Pitfalls
- Billing C449 before the 13-week threshold has passed will result in automatic rejection; ensure the admission date is tracked accurately in your billing software.
- Exceeding the maximum of 6 visits per month per patient will trigger a rejection; if you are providing concurrent or supportive care, the limit drops to 2 per week.
- Attempting to bill C449 alongside emergency Special Visit Premiums is prohibited; if an emergency assessment is required, use the appropriate 'A' prefix code and premium instead.
Billing Tips
- If you are the Most Responsible Physician (MRP) and do not receive hospital remuneration, always append the E083 premium to C449 to increase the fee by 30% on weekdays.
- When working in an ICU or CCU setting, remember to add the C101 premium to C449, provided you are not already claiming supportive or critical care team fees.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Assessment
Hospital and Institutional Consultations and Assessments
See General Preamble to for rules regarding Non-Emergency Hospital In-patient Services.
For emergency calls and other special visits to in-patients, use General Listings 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.