C649 – Partial Assessment - General Thoracic Surgery
OHIP Surgical Procedures Code — General Thoracic Surgery (64) · Schedule of Benefits
A subsequent visit rendered by a specialist in General Thoracic Surgery (64) for a non-emergency acute care hospital in-patient, after the thirteenth week of care. This service is identified by its 'C' prefix, indicating it is for acute care hospital – non-emergency in-patient services as per . This service has a maximum of 6 per patient per month.
When to Use
- Use C649 for routine follow-up assessments of an inpatient by a Thoracic Surgeon once the patient has exceeded the 13-week threshold of continuous care.
- Apply this code when managing stable thoracic surgical patients who no longer require the intensive monitoring associated with C642 or C643.
Common Pitfalls
- Billing C649 before the 13-week period has elapsed; ensure the date of service is strictly after the 13th week of the current hospital episode.
- Exceeding the monthly limit of 6 services per patient, which will trigger automatic rejections from the Ministry.
- Confusing C649 with C648; C649 is specifically for the period beyond 13 weeks, whereas C648 covers the 5th through 13th weeks.
Billing Tips
- Always append the C101 premium when the assessment occurs within an ICU or CCU setting to maximize the claim value.
Effective: June 1, 2025
Consultations and Visits
General Thoracic Surgery (64)
Subsequent Visit
Hospital and Institutional Consultations and Assessments, Assessments
All insured services must be documented in appropriate records. The Act requires that the record establish that: an insured service was provided; the service for which the account is submitted is the service that was rendered; and the service was medically necessary.
The 'C' prefix indicates this service is for acute care hospital – non-emergency in-patient services.
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