C647 – Long-term care in-patient visit
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A subsequent visit is any routine assessment in hospital following the hospital admission assessment, as defined in . This service applies to non-emergency in-patient services in an acute care hospital, identified by the 'C' prefix as per . The visit includes all specific elements of an assessment as outlined in . This service is specifically for subsequent visits rendered from the sixth to thirteenth week inclusive of hospitalization. It may also include: - Attendance at Surgery: If the referring physician is asked to be present by the patient or patient's representative but does not assist, the attendance constitutes a hospital subsequent visit. - Multidisciplinary care: When multiple physicians in different disciplines are required for a complex medical condition, each physician's visit constitutes a subsequent visit.
When to Use
- Use C647 for routine subsequent visits occurring between the 6th and 13th week of a patient's continuous hospital admission.
- Use C647 when a physician is requested to attend a surgery as an observer without providing surgical assistance or performing a procedure.
- Use C647 when providing a multidisciplinary assessment for a complex patient where multiple specialists are required to manage the same admission.
Common Pitfalls
- Exceeding the OHIP frequency limit of 3 visits per week for the 6-to-13-week period, which will result in automatic claim rejection.
- Billing C647 for an acute intercurrent illness after the 5th week; these must be billed as C121 to bypass the weekly frequency limits.
- Failing to recognize that the visit count is tied to the patient's original admission date, even if the patient is transferred to your service mid-stay.
Billing Tips
- If you are the Most Responsible Physician (MRP) and meet the remuneration criteria, always append E083 to C647 to capture the 30% premium.
- If the patient requires an assessment on a weekend or holiday during this period, use E084 instead of E083 to secure the higher 45% premium.
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