1What Is the C083 OHIP Code?
What is C083?
C083 is an OHIP billing code used for a specific assessment conducted by plastic surgeons on hospital in-patients in Ontario. This service focuses on a distinct clinical inquiry, such as evaluating whether a laceration warrants formal repair in the operating theatre.
In plastic surgery, these assessments are crucial for making informed surgical decisions and typically occur during a patient's hospital stay. Despite their importance, these assessments can be overlooked due to the busy nature of hospital environments and the complexities of patient needs during admissions.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A083 | A083 Specific assessment | As needed | Applicable for out-patient settings, same fee as C083. |
| C084 | C084 Specific re-assessment | As needed | Used for follow-up assessments in hospital. |
| A084 | A084 Partial assessment | As needed | Covers partial assessments in out-patient settings. |
| A935 | A935 Special surgical consultation | As needed | Applies to detailed surgical consultations at a higher fee. |
3Eligibility Requirements
Eligibility for Billing C083
According to the OHIP Schedule of Benefits, C083 can be billed by plastic surgeons performing a specific assessment for hospital in-patients. Importantly, it may be the major pre-operative visit if the decision to perform surgery is made during this encounter, and regardless of the interval between this assessment and forthcoming surgery.
Virtual Care
C083 assessments may also be rendered virtually, but only through video call, and should be billed as C083A if so. Virtual assessments conducted over the phone are not eligible for this billing.
Surgical Visit Considerations
For surgeons, the hospital admission assessment can only be claimed if it is the major pre-operative visit as previously defined.
4What Your Clinical Note Must Show
Documentation of service time is critical.
- Record the start and end time of the assessment in the patient's medical record.
Ensure comprehensive assessment documentation.
- Include a full history, functional inquiry, and examination except where not indicated or refused by the patient.
5Weak vs. Strong Note Examples
The strong note succeeds by providing complete time documentation, detailed history, and clear decision-making rationale, whereas the weak note lacks these essential details.
08/01/2023: Patient assessed for a scar. Decision made.
08/01/2023: Started assessment at 15:00, concluded at 15:45. Patient presents with a 5cm facial laceration. Relevant history includes no previous surgeries and a significant scar resolution concern. Functional inquiry normal for all other systems. Consulted on possible surgical intervention; decision made for theatre repair.
- Complete time documentation
- Detailed patient history
- Rationale for decision-making
