C602 – Subsequent Visits - First Five Weeks per Visit
OHIP Surgical Procedures Code — Cardiology (60) · Schedule of Benefits
A subsequent visit is a routine assessment in hospital following the hospital admission assessment. C602 is specifically for subsequent visits rendered by a specialist in Cardiology (specialty 60) to a non-emergency acute care hospital in-patient. This service is limited to one per patient, per day, during the first five weeks after the patient's admission. If the complexity of the medical condition requires the services of several physicians in different disciplines, each physician visit constitutes a subsequent visit. When a patient is transferred, subsequent visit timing is calculated from the original admission date.
When to Use
- Use C602 for routine daily inpatient rounds performed by a Cardiologist within the first 35 days of the original hospital admission date.
- Use C602 when providing follow-up care for a patient transferred from another service, provided the visit occurs within the 35-day window from the initial admission.
Common Pitfalls
- Billing C602 more than once per day for the same patient, as the OHIP schedule strictly limits this to one visit per day regardless of the number of times the patient is seen.
- Failing to switch to the appropriate 'long-stay' subsequent visit code (e.g., C608) once the patient exceeds the five-week (35-day) threshold from the original admission date.
- Attempting to bill C602 concurrently with C121, as C121 is reserved for intercurrent illnesses and is mutually exclusive with standard subsequent visit codes.
Billing Tips
- If you are the Most Responsible Physician (MRP) and meet the remuneration criteria, always append E083 for weekday visits or E084 for weekend/holiday visits to increase the base fee by 30% or 45% respectively.
- If the patient is located in a CCU, ensure you add the C101 premium to C602 to capture the additional value for intensive care setting services.
Effective: June 1, 2025
Consultations and Visits
Cardiology (60)
Assessment
Hospital and Institutional Consultations and Assessments
All insured services must be documented in appropriate records to establish that: an insured service was provided; the service for which the account is submitted is the service that was rendered; and the service was medically necessary.
For emergency calls and other special visits to in-patients, use General Listings and Premiums when applicable.
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