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C614

C614Medical Specific Re-Assessment

OHIP Surgical Procedures Code — Haematology (61) · Schedule of Benefits

A medical specific re-assessment rendered by a specialist in Haematology (61) to a patient in an acute care hospital as a non-emergency in-patient service. This service requires a full, relevant history and physical examination of one or more systems, as defined in the Schedule on page . This service is typically used for follow-up care in the hospital or may serve as a hospital admission assessment if the physician has previously assessed the patient for the same illness within the last 90 days, as per rules on page .

When to Use

  • Use C614 for a hospital admission assessment when you have already assessed the patient for the same haematological condition within the previous 90 days.
  • Use C614 for routine follow-up visits for an established haematology in-patient who does not meet the criteria for a more complex C612 or C613 assessment.

Common Pitfalls

  • Billing C614 when the patient has not been seen by you for the same illness within the last 90 days, which may trigger a rejection or audit for a higher-level consultation code.
  • Failing to document a full, relevant history and physical examination of at least one system, as C614 is not a 'brief' visit code and requires a formal assessment note.

Billing Tips

  • If the patient is admitted to the ICU or CCU, remember to add the C101 premium to your C614 claim to maximize the value of the hospital visit.
  • Unlike office-based re-assessments, C614 is exempt from the 12-month frequency limit when used for hospital admission purposes.
Provider Fee$0.00
Specialist Fee$65.85

Effective: June 1, 2025

Category

Consultations and Visits

Subcategory

Haematology (61)

Service Type

Assessment

Code Classes

Hospital and Institutional Consultations and Assessments, Assessments

A full, relevant history and physical examination of one or more systems must be documented in the patient's medical record as per the definition of a medical specific re-assessment on .

As with all assessments, the service must include a direct physical encounter with the patient and all other specific elements of assessments as defined on .

See General Preamble for the definition and payment rules for Medical Specific Re-assessment. The limit of two per 12-month period does not apply to specific re-assessments rendered for hospital admissions, such as C614.

See General Preamble to for rules regarding non-emergency hospital in-patient services ('C' prefix codes).

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