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C609
C609 – Subsequent Visit - After Thirteenth Week
OHIP Surgical Procedures Code — Cardiology (60) · Schedule of Benefits
A subsequent visit is a routine assessment in hospital following the hospital admission assessment. This specific service, C609, applies to visits rendered by a cardiologist after the thirteenth week of the patient's hospital admission. As per , subsequent visits include any routine assessment in the hospital, attendance at surgery if not assisting, and care provided as part of a multidisciplinary team. The service includes the specific elements of an assessment as defined in , such as a history and physical examination, arranging further care, and communication with the patient.
When to Use
- Use C609 for routine daily assessments of a cardiology patient who has remained in the hospital for more than 13 consecutive weeks.
- Use this code for multidisciplinary team care or routine hospital follow-ups once the patient has crossed the 13-week threshold of their current admission.
Common Pitfalls
- Billing C609 before the 13-week mark; ensure the patient's actual admission date exceeds 91 days to avoid automatic rejection.
- Attempting to bill C609 alongside emergency special visit premiums; these are mutually exclusive and require the use of 'A' prefix codes for urgent assessments.
- Failing to account for patient transfers; remember that while the 13-week limit for payment eligibility tracks the original admission date, the specific code selection (C602 vs C609) for a new physician is determined by the date they first assumed care.
Billing Tips
- If you are the Most Responsible Physician (MRP), always append E083 for weekday visits or E084 for weekend/holiday visits to maximize the base fee of C609.
- If the patient is located in a CCU, ensure you add the C101 premium to the C609 claim, provided no other comprehensive care or team fees are being billed for that visit.
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