C775 – Comprehensive geriatric consultation
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A comprehensive geriatric consultation provided to a non-emergency hospital in-patient. This service is subject to the same conditions as A775. Per , a consultation is an assessment rendered following a written request from a referring physician, nurse practitioner, or dental surgeon because of the complexity, seriousness, or obscurity of the case. The service includes all work necessary to prepare a written report with findings, opinions, and recommendations for the referring practitioner.
When to Use
- Use C775 for a comprehensive geriatric assessment of a hospital inpatient where a formal written request is received from the attending physician for an opinion on complex multi-system geriatric issues.
- Use C775 when providing a consultative service to an inpatient that meets the definition of a consultation under GP16, distinguishing it from a routine follow-up assessment (C770).
Common Pitfalls
- Billing C775 for a patient seen in the Emergency Department; C-prefix codes are strictly for hospital inpatients, whereas A775 must be used for ED settings.
- Attempting to bill a special visit premium with C775; if a premium is required for an urgent non-elective visit, you must use A775 instead.
- Exceeding the consultation frequency limit of one per 12-month period for the same diagnosis, which results in an automatic downgrade to a lower assessment fee.
Billing Tips
- Ensure the written referral request is clearly documented in the hospital chart, as the absence of a formal request will trigger a reduction to a lower assessment fee upon audit.
- If you provide a follow-up visit for the same condition within the same admission, bill C770 rather than repeating C775.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Consultation
Hospital and Institutional Consultations and Assessments, Consultations
A copy of the written request for the consultation, signed by the referring practitioner, must be kept in the consulting physician's medical record (unless a common medical record is used, e.g., in a hospital).
The written request must identify the consultant by name, the referring practitioner by name and billing number, and the patient by name and health number.
The written request must set out the information relevant to the referral and specify the service(s) required.
The consultant must prepare a written report including findings, opinions, and recommendations and provide it to the referring practitioner.
Subject to the same conditions as A775.
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