C629 – Subsequent Visit - After Thirteenth Week
OHIP Surgical Procedures Code — Clinical Immunology (62) · Schedule of Benefits
C629 is a subsequent visit for a non-emergency hospital in-patient rendered by a Clinical Immunology specialist. This service applies to routine assessments following the patient's admission to the hospital, specifically for visits occurring after the thirteenth week of the patient's stay. As a subsequent visit, it is subject to the general rules outlined in the Schedule of Benefits (see ), and includes all common elements of insured services (see , ) and the specific elements of assessments (see ). The service requires a direct physical encounter with the patient, including history taking and physical examination as appropriate. Visits for acute intercurrent illness during this period may be claimed separately using C121 and are not subject to the monthly limit. When a hospital in-patient is transferred from one physician to another, subsequent visits by the second physician are calculated based on the patient's original admission date.
When to Use
- Use C629 for routine, non-acute follow-up assessments of an admitted Clinical Immunology patient once the stay exceeds 13 weeks.
- Use C629 when assuming care of a patient transferred from another physician, ensuring the visit count is based on the original hospital admission date rather than the transfer date.
Common Pitfalls
- Billing C629 for an acute intercurrent illness; use C121 instead to avoid the monthly visit limit and ensure appropriate compensation.
- Attempting to claim E083 or E084 premiums if you receive direct or indirect hospital remuneration for in-patient services without a corresponding reduction in that salary.
- Billing C629 on the same day as E083 and E084, which is explicitly prohibited by the Schedule of Benefits.
Billing Tips
- If you are the Most Responsible Physician (MRP) and meet the remuneration criteria, append E083 to C629 for weekdays or E084 for weekends/holidays to increase the fee by 30% or 45% respectively.
- If the patient is in an ICU or CCU setting, remember to add the C101 premium to your C629 claim to capture the additional institutional complexity.
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