1What Is the C074 OHIP Code?
C074 refers to the medical specific re-assessment by specialists for non-emergency hospital in-patients aged 65 or older, or for dementia assessments. Commonly, this assessment is essential for patients needing follow-ups focused on particular issues, such as delirium or mobility post-intervention.
This code is indispensable in geriatric care, allowing specialists to concentrate on the patient's problem without undertaking a comprehensive full-system assessment each time. Because of its specificity, C074 ensures geriatricians can efficiently monitor changes or improvements without redundant work.
C074 might be missed if not properly documented as targeting a specific condition like delirium. Familiarity with the patient's history and urgent issues usually triggers this assessment, and maintaining meticulous records is key.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A073 | Medical specific assessment | Specialty general assessment for new patients or new issues | Initial comprehensive assessment for geriatric patients, done in an out-patient setting. |
| C073 | Medical specific assessment | Initial assessment | Complete assessment within an in-patient setting, typically at admission. |
| A071 | Complex medical specific re-assessment | Limited to two per year | Intensive reassessment involving multiple systems or complex decision-making. |
| A074 | Medical specific re-assessment | Out-patient reassessment equivalent | Re-assessment focusing on a particular geriatric issue outside the hospital. |
3Eligibility Requirements
To bill for C074, the following conditions must be satisfied:
- Setting: Non-emergency hospital in-patient services for geriatric patients, generally within a geriatrics unit.
- Patient Age/Condition: The patient must be at least 65 years old, or the re-assessment should be for conditions like dementia, regardless of age.
- Assessment Scope: Requires a full, relevant history and examination of one or more systems while focusing on the specific issue identified during a previous evaluation.
- Frequency Limit: Specific re-assessments, including C074, are limited to two per patient per physician within a consecutive 12-month period, except during hospital admissions. Exceeding this limit defaults to a lesser fee.
4What Your Clinical Note Must Show
Record time accurately for C074 service:
- Start and end times must be captured in the patient's medical record.
- Ensuring compliance with General Preamble GP7 is mandatory for payment.
Document a detailed history and examination findings:
- Focus on the specific system or problem area.
- Include all relevant patient findings and history updates.
- Record any changes in management or treatment decisions.
5Weak vs. Strong Note Examples
The strong note succeeds due to its specificity and actionable detail, providing clear evidence of clinical decision-making, while the weak note lacks sufficient detail on both findings and actions taken.
Patient reassessed for previous issues. No new findings. Time: 09:00-09:15.
Re-assessment performed for post-operative delirium: noted improvement since previous visit, discussed medication adjustment options.
- Detailed observations of changes in mental status.
- Recorded discussion of treatment plan modifications.
- Time: 09:00-09:20.
