C627 – Subsequent Visit - Sixth to Thirteenth Week Inclusive
OHIP Surgical Procedures Code — Clinical Immunology (62) · Schedule of Benefits
A subsequent visit by a Clinical Immunology specialist to a non-emergency hospital in-patient. This service is applicable for patients between the sixth and thirteenth week of admission, inclusive. According to the General Preamble (), a subsequent visit is a routine assessment following the hospital admission assessment. This fee includes multidisciplinary care visits and attendance at surgery if requested by the patient and the physician does not assist.
When to Use
- Use C627 for routine follow-up assessments of an admitted patient by a Clinical Immunology specialist occurring between the 6th and 13th week of their hospital stay.
- Use C627 when attending multidisciplinary team meetings or rounds for a patient within this specific timeframe, provided no other counseling or psychotherapy codes are claimed.
Common Pitfalls
- Billing C627 more than three times in a single week will trigger an automatic rejection as it exceeds the maximum frequency allowed for routine subsequent visits.
- Attempting to bill C627 on the same day as counseling services or psychiatric care will result in a billing conflict, as these services are mutually exclusive under GP58 and GP56.
- Failing to switch to C121 when an acute intercurrent illness requires an additional visit beyond the weekly limit will lead to claim denials for exceeding the routine visit cap.
Billing Tips
- If you are the Most Responsible Physician (MRP) and not receiving direct hospital remuneration for the service, ensure you append E083 to C627 to capture the 30% premium.
- When providing care in an ICU or CCU setting, append C101 to C627 to claim the flat-rate premium, provided you are not already claiming team-based fees.
Effective: June 1, 2025
Consultations and Visits
Clinical Immunology (62)
Assessment
Hospital and Institutional Consultations and Assessments
For emergency calls and other special visits to in-patients, use General Listings and Premiums when applicable - see General Preamble to .
See General Preamble to for rules regarding non-emergency hospital in-patient services.
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