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C628
C628 – Concurrent Care
OHIP Surgical Procedures Code — Clinical Immunology (62) · Schedule of Benefits
Concurrent care is any routine assessment rendered in hospital by the consultant following the consultant's first major assessment of the patient when the family physician remains the most responsible physician but the latter requests continued directive care by the consultant.
When to Use
- Use C628 when you have completed an initial consultation (C622) and the MRP requests your ongoing, directive input for a specific clinical issue while they retain overall responsibility for the patient.
- Use C628 for routine daily or periodic hospital assessments when the patient's condition requires your specialist oversight but does not meet the criteria for more intensive codes like C624 (Subsequent Hospital Visit).
Common Pitfalls
- Billing C628 as the MRP is a common rejection; this code is strictly for the consultant providing directive care at the request of the MRP.
- Attempting to claim special visit premiums (e.g., K963) with C628 will result in rejection, as concurrent care is considered a routine assessment performed during rounds.
- Exceeding the weekly frequency limits (4 per week for the first week, 2 per week thereafter) will trigger automatic claim adjustments or rejections.
Billing Tips
- If you are seeing a patient in the ICU or CCU, you can append the C101 premium to C628 to increase the total reimbursement for the visit.
- Ensure your documentation clearly reflects a request from the MRP for your continued directive care to justify the use of C628 over standard subsequent visit codes.
Provider Fee$0.00
Specialist Fee$34.10
Effective: June 1, 2025
Category
Consultations and Visits
Subcategory
Clinical Immunology (62)
Service Type
Assessment
Code Classes
Assessments, Hospital and Institutional Consultations and Assessments
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