C800 – Midwife or Aboriginal Midwife-requested genetic assessment
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A midwife or Aboriginal midwife-requested genetic assessment for a non-emergency hospital in-patient. This service is subject to the same conditions as A800. As an assessment, it includes the specific elements outlined in the Schedule of Benefits (see ), such as a direct physical encounter with the patient, history taking, performing necessary procedures not otherwise billed, making arrangements for related care, and discussion with the patient or representative. The 'C' prefix designates this service for acute care hospital non-emergency in-patient services (, ). For emergency calls and other special visits to in-patients, the corresponding General Listings code (A800) and applicable Special Visit Premiums should be claimed instead of C800 (, ).
When to Use
- Use C800 when performing a genetic assessment on a non-emergency hospital inpatient specifically following a formal written request from a midwife or Aboriginal midwife.
- Use this code for scheduled, non-urgent inpatient genetic evaluations where the patient is already admitted and the assessment does not qualify for Special Visit Premiums.
Common Pitfalls
- Billing C800 instead of A800 when the service is provided as an emergency or requires a special visit premium, which will result in a rejection or audit recovery.
- Failing to document exact start and stop times in the medical record, which is a mandatory requirement for C800 and will lead to claim rejection.
- Missing the written referral from the midwife in the patient's chart, which triggers a reduction to a lesser fee upon audit.
Billing Tips
- Ensure the written request from the midwife is clearly labeled and filed in the permanent medical record before submitting the claim to avoid fee reduction.
- If the patient is in the ICU or CCU, remember to add the C101 premium to the C800 claim to capture the additional institutional setting fee.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Assessment
Hospital and Institutional Consultations and Assessments, Assessments
The service is eligible for payment only if start and stop times of the service are recorded in the patient's permanent medical record.
The written request from the midwife or aboriginal midwife must be retained on the patient’s permanent medical record, or the amount payable for the service will be reduced to a lesser fee.
This service is subject to the same conditions as A800.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.