The use of subsequent visit codes post-operatively

The Education and Prevention Committee (EPC) releases bulletins providing answers to OHIP billing questions posed by physicians. In Volume 5, No. 3 they discuss the use of subsequent visit codes post-operation. This blog briefly summarizes the main points from the bulletin.

1.  Surgeons are not eligible for billing C122 and C123 for post-operative subsequent visits, however C124 subsequent visit is eligible for payment on the day of discharge. General surgeon's may also be eligible for C032 for the first post-operative visit.

2. In cases where surgeons are rotating on call where the surgeon on call is to visit all other physician's patients, the on call physician is not eligible to bill C124. Only the operating surgeon (MRP) is eligible for payment of C124. As long as the operating surgeon fulfills all requirements for billing C124 within 48 hours of discharge he/she can bill C124 even if the visit on the day of discharge is from the on-call physician.

3. In cases where an acute care nurse practitioner dictates the discharge summary and signs on behalf of the MRP, the MRP is not eligible for payment of C124.

4. If a patient dies during the night C124 is not payable as a subsequent visit was not performed. A771 may be billed for certification of death.

Reference: https://www.oma.org/Resources/Documents/0503EPC_Bulletin.pdf