C642 – Subsequent Visit (General Thoracic Surgery)
OHIP Surgical Procedures Code — General Thoracic Surgery (64) · Schedule of Benefits
A subsequent visit for a non-emergency in-patient in an acute care hospital, rendered by a specialist in General Thoracic Surgery. According to , this is any routine assessment in a hospital following the hospital admission assessment. When the complexity of a patient's condition requires services from several different specialists, each physician's visit constitutes a subsequent visit. If a referring physician is asked to be present at a surgery but does not assist, this attendance also constitutes a hospital subsequent visit. As an assessment, this service includes the specific elements described in : - A direct physical encounter with the patient, including history and physical examination. - Other inquiry to arrive at an opinion about the patient's condition. - Performing any procedure(s) during the same encounter unless separately billable. - Arranging for related assessments, procedures, or therapy. - Arranging for follow-up care. - Discussion and advice to the patient or their representative. - Monitoring the patient's condition as medically indicated.
When to Use
- Use C642 for routine daily ward rounds for a thoracic surgery patient during the first 5 weeks of their hospital admission.
- Use C642 when you are requested to attend a surgery as a specialist but do not perform or assist in the procedure, provided you perform a physical encounter and document the assessment.
- Use C642 when providing a subsequent assessment for a patient who has been transferred to your service from another physician, using the patient's original hospital admission date to determine the visit frequency limit.
Common Pitfalls
- Billing C642 more than once per day; subsequent visits are strictly limited to one per patient per day, regardless of the number of times you see the patient.
- Failing to account for the 'admission date' correctly when taking over a patient; the frequency limits (e.g., 3/week after 5 weeks) are tied to the original hospital admission date, not the date you assumed care.
- Attempting to bill C642 alongside C121 for the same patient on the same day, which is explicitly prohibited by the billing rules.
Billing Tips
- If you are the Most Responsible Physician (MRP), always append the E083 premium to C642 to receive an additional 30% fee, provided you meet the hospital remuneration criteria.
- If the patient is in an ICU or CCU, ensure you add the C101 premium to C642, as it is payable when no other separate fee is claimed for the visit.
Effective: June 1, 2025
Consultations and Visits
General Thoracic Surgery (64)
Assessment
Hospital and Institutional Consultations and Assessments, Assessments
The service must be documented in the patient's medical record, fulfilling the requirements for an assessment as per and .
When a hospital in-patient is transferred from one physician to another physician, subsequent visits by the second physician are calculated based on the actual admission date of the patient.
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