C723 – Medical specific assessment (Occupational Medicine) - Hospital In-Patient
OHIP Surgical Procedures Code · Schedule of Benefits
A medical specific assessment is a service rendered by a specialist in Occupational Medicine to a hospital in-patient. It requires a full history of the presenting complaint and a detailed examination of the affected part(s), region(s), or system(s) needed to make a diagnosis, and/or exclude disease, and/or assess function.
When to Use
- Use C723 for the initial hospital admission assessment when you are the primary specialist in Occupational Medicine managing the patient's care.
- Use C723 when a patient is transferred to your service for a new, distinct occupational health issue that requires a full history and detailed examination.
Common Pitfalls
- Billing C723 when a prior assessment for the same presenting illness has occurred within the previous 90 days, which will trigger a rejection or adjustment to a re-assessment code.
- Exceeding the annual limit of 4 combined services for C723 and C721, which results in automatic fee reductions for subsequent claims.
- Attempting to bill C723 in addition to a consultation code (e.g., C720) for the same patient encounter, as only one assessment/consultation is payable per admission.
Billing Tips
- Ensure your documentation explicitly outlines the 'detailed examination' of the specific systems involved, as this is the primary audit trigger for this code.
- If you are called to the hospital for an urgent, non-elective assessment, remember to append the appropriate Special Visit Premium (C960-C997) to maximize the claim value.
Effective: April 1, 2026
Non-Emergency Hospital In-Patient Services
Assessment
Full history of the presenting complaint.
Detailed examination of the affected part(s), region(s), or system(s) needed to make a diagnosis, and/or exclude disease, and/or assess function.
C723 constitutes the admission assessment if the specialist assesses the patient in the ED/OPD and subsequently admits them, provided no prior assessment for the same illness occurred within 90 days.
Age-based fee premiums do not apply to this code.
Chronic Disease Assessment Premium (E078) is not payable for hospital in-patients.
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