E083 – Subsequent visit by the MRP
OHIP Surgical Assists Code — GENERAL PREAMBLE · Schedule of Benefits
A premium payable to the Most Responsible Physician (MRP) for a subsequent visit or palliative care visit, which adds 30% to the fee of the primary service. This applies to subsequent visits and codes C122, C123, C124, C126, C142, C143, C882, or C982. Examples of eligible subsequent visits include C002, C007, C009, C132, C137, C139, C032, C037, or C039. This premium has specific payment rules, including restrictions on co-billing with E084 and C121, and financial stipulations regarding hospital remuneration.
When to Use
- Use E083 when you are the Most Responsible Physician (MRP) performing a standard subsequent hospital visit (e.g., C002, C007, C032) to increase the base fee by 30%.
- Use E083 for palliative care visits (e.g., C122, C123, C124) where you are the MRP, provided the patient is not in a designated palliative care bed in a Long-Term Care facility.
Common Pitfalls
- Attempting to co-bill E083 with E084; only one of these premiums is eligible per patient per day.
- Billing E083 with C121 when C121 is used for an intercurrent illness, as the premium is strictly prohibited in this specific scenario.
- Failing to account for hospital remuneration; you must ensure your hospital compensation structure allows for this premium or that your hospital pay has been adjusted accordingly.
Billing Tips
- Always verify your MRP status before appending E083, as it is strictly reserved for the physician coordinating the patient's care.
- Ensure the primary service code is one of the eligible subsequent visit codes listed in the General Preamble to avoid automatic rejection.
Percentage Premium: 0.3%
This code applies a percentage increase to the base procedure fee
Effective: July 1, 2013
GP. General Preamble
GENERAL PREAMBLE
PercentageIncrease
Other Premiums (including After Hours Procedure Premiums)
Only one of E083 or E084 is eligible for payment per patient per day.
E083 or E084 are only eligible for payment: a. if the physician establishes that he or she does not receive any direct or indirect remuneration from a hospital or hospital foundation for rendering in-patient clinical services; or b. where the physician receives any direct or indirect remuneration from a hospital or hospital foundation for rendering in-patient clinical services, if the physician establishes that such remuneration has been reduced by an amount equal to the amount that would be eligible for payment to the physician had he or she not received any such direct or indirect remuneration.
E083 or E084 are not eligible for payment for palliative care visits to patients in designated palliative care beds in Long-Term Care Institutions.
E083 or E084 are not applicable to any other service or premium.
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