C612 – Subsequent Visits, First Five Weeks per Visit
OHIP Surgical Procedures Code — Haematology (61) · Schedule of Benefits
A subsequent visit is any routine assessment in hospital following the hospital admission assessment. This code is for a subsequent visit rendered by a physician with the specialty of Haematology (61) to an in-patient during the first five weeks of their hospital admission. As per , this assessment includes a direct physical encounter, history taking, arranging for related assessments or therapy, and providing advice to the patient. It may also include attendance at surgery if requested by the patient but not assisting, or care as part of a multidisciplinary team.
When to Use
- Use for routine daily follow-up assessments of a haematology inpatient within the first 35 days of their hospital admission.
- Use when performing a multidisciplinary team assessment or providing haematological advice for an inpatient where you are not the Most Responsible Physician (MRP).
Common Pitfalls
- Do not bill C612 if you are performing a non-elective special visit; you must use an 'A' prefix code from the General Listings instead as per GP43/GP69.
- Do not attempt to claim special visit premiums (e.g., K960 series) with C612, as these are strictly prohibited for 'C' prefix subsequent visits.
- Billing C612 beyond the 35-day window will result in rejection; switch to C617 for visits occurring after the first five weeks.
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 maximize the base fee.
- Ensure your documentation clearly reflects the date of the original hospital admission, as subsequent visit limits are calculated based on that date, not the date you assumed care.
Effective: June 1, 2025
Consultations and Visits
Haematology (61)
Assessment
Hospital and Institutional Consultations and Assessments, Assessments
For Services not listed, refer to Internal Medicine Section.
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