C648 – Subsequent Visit - General Thoracic Surgery
OHIP Surgical Procedures Code — General Thoracic Surgery (64) · Schedule of Benefits
A subsequent visit is any routine assessment in hospital following the hospital admission assessment. This service applies to non-emergency in-patient services provided by a specialist in General Thoracic Surgery. As per , if the patient's medical condition requires services from several physicians in different specialties, each physician's visit constitutes a subsequent visit. If the referring physician is asked to be present at surgery but does not assist, the attendance constitutes a subsequent visit.
When to Use
- Use for routine daily ward rounds for thoracic surgery patients who are outside the post-operative global period of their surgery.
- Use when providing a consultative follow-up assessment for a patient admitted under a different service (e.g., Internal Medicine) where you are acting as a consulting specialist rather than the MRP.
- Use for non-emergency, non-post-operative thoracic assessments occurring during a prolonged hospital stay.
Common Pitfalls
- Billing C648 during the post-operative period of a non-Z prefix surgery; these services are considered included in the surgical fee and are not separately payable.
- Attempting to bill C648 on the same day as MRP-specific visit codes like C122 or C123, which will result in a rejection due to duplicate assessment claims for the same patient.
- Exceeding the frequency limits (1 per day for 5 weeks, then 3 per week, then 6 per month) without documenting an acute intercurrent illness that would justify using C121 instead.
Billing Tips
- If you are the MRP, ensure you append the E083 or E084 premium to C648 to maximize the claim value, provided you do not receive separate hospital remuneration for the service.
- If the patient is transferred to your care from another physician, remember that the frequency limit clock for C648 is based on the patient's original hospital admission date, not the date of transfer.
Effective: June 1, 2025
Consultations and Visits
General Thoracic Surgery (64)
Assessment
Hospital and Institutional Consultations and Assessments
All insured services must be documented in the patient's medical record to establish that an insured service was provided, the service claimed is the service rendered, and the service was medically necessary. See .
As an assessment, this service must include a direct physical encounter, history taking, physical examination, and documentation of the same, as per the specific elements of assessments on .
C-prefix codes are for non-emergency in-patient services in an acute care hospital.
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