C624 – Medical Specific Re-Assessment
OHIP Surgical Procedures Code — Clinical Immunology (62) · Schedule of Benefits
C624 is a medical specific re-assessment rendered by a Clinical Immunology specialist (specialty 62) for a non-emergency hospital in-patient. The 'C' prefix designates this service for acute care hospital non-emergency in-patient settings (). The service requires a full, relevant history and physical examination of one or more systems, as defined on . This service may constitute an admission assessment if the admitting physician has previously assessed the patient for the same illness within 90 days of admission (). While specific re-assessments are generally limited to two per 12-month period, this limit explicitly does not apply to re-assessments rendered for hospital admissions, such as C624 ().
When to Use
- Use C624 when performing a subsequent hospital visit for an existing immunology patient where a full, relevant history and physical examination of one or more systems is required.
- Use C624 as an admission assessment if you have already assessed the patient for the same condition within the previous 90 days, as this qualifies as a re-assessment rather than a new consultation.
- Use C624 for complex in-patient follow-ups that exceed the scope of a standard subsequent visit (C622) but do not meet the criteria for a formal consultation (C620).
Common Pitfalls
- Billing C624 in addition to a psychotherapy or psychiatric care code on the same day is rejected unless you document a distinct, unrelated diagnosis for each service.
- Attempting to bill C624 when a patient has been transferred from another physician during the same admission often triggers an automatic adjustment to a lower assessment fee.
- Failing to document a full, relevant history and physical examination of at least one system will lead to recovery of funds during an audit, as this is a mandatory requirement for the 'Specific' designation.
Billing Tips
- If the patient is located in an ICU or CCU, ensure you append the C101 premium to C624 to capture the additional flat fee for the intensive care setting.
- Unlike office-based specific assessments, the two-per-12-month limit does not apply to C624, allowing you to bill it as frequently as medically necessary for hospital in-patients.
Effective: June 1, 2025
Consultations and Visits
Clinical Immunology (62)
Assessment
Hospital and Institutional Consultations and Assessments, Assessments
In addition to common medical record requirements, the service requires documentation of a full, relevant history and physical examination of one or more systems.
For Services not listed, refer to Internal Medicine Section.
See General Preamble to for 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 .
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