C760 – Complex endocrine neoplastic disease assessment
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A complex endocrine neoplastic disease assessment rendered to a non-emergency hospital in-patient by a specialist in Endocrinology & Metabolism (15). As a 'C' prefix code, this service is designated for acute care hospital non-emergency in-patient services as outlined in . The payment conditions for this service are identical to those for A760. As per and , when more than one assessment is rendered during the same visit by the same physician, only one assessment is payable.
When to Use
- Use C760 for a non-emergency, subsequent hospital assessment of a patient with a complex endocrine neoplasm, such as a pheochromocytoma or multiple endocrine neoplasia (MEN) syndrome.
- Use this code when managing the endocrine complications of a hospitalized patient where the complexity of the neoplastic disease requires a specialist-level assessment that exceeds the scope of a standard subsequent visit (A005).
Common Pitfalls
- Billing C760 for emergency or urgent assessments; these must be billed using the 'A' prefix codes (e.g., A760) combined with the appropriate Special Visit Premium (SVP) codes.
- Attempting to claim C760 alongside another assessment code on the same day; OHIP will reject the second assessment as only one is payable per patient per physician per day.
- Failing to recognize that C760 is ineligible for Special Visit Premiums, leading to claim rejections if an SVP is attached to the same claim.
Billing Tips
- If the patient is located in an ICU or CCU, ensure you append the C101 premium to the C760 claim to capture the additional intensity of the setting.
- Always verify that the clinical documentation supports the 'complex' nature of the endocrine neoplastic disease, as this is the primary differentiator from a standard subsequent visit code.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Assessment
Hospital and Institutional Consultations and Assessments, Assessments
Subject to the same conditions as A760.
For emergency calls and other special visits to in-patients, use General Listings and Premiums when applicable (see to ).
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