C084 OHIP Billing Code: Plastic Surgery

1What Is the C084 OHIP Code?

C084 refers to a Specific re-assessment in Plastic Surgery, used for in-patient evaluations such as monitoring a flap, graft, or complex wound during hospital admissions. This code ensures that a thorough and relevant history and physical examination are conducted on one or more systems.

Commonly missed due to oversight on re-assessment frequency or incomplete documentation, C084 is integral to managing inpatient care in Plastic Surgery efficiently. Proper use of this code ensures continued care and monitoring of surgical developments post-procedure.

2Related Codes

Code	Name	Frequency	Description
A083	Specific assessment	N/A	Used for initial specific assessments in the Plastic Surgery setting.
C083	Specific assessment	N/A	Used for specific assessments of in-patients in Plastic Surgery.
A084	Partial assessment	N/A	Employed for rendering similar out-patient services.
A935	Special surgical consultation	N/A	In-depth consultation related to surgery in Plastic Surgery.

3Eligibility Requirements

Eligible for rendering by specialists, a C084 service involves a full relevant history and physical examination. It is limited to two specific re-assessments per patient per physician within a consecutive 12-month period, except for those linked to hospital admissions. To qualify, detailed time records, indicating start and end of service, must be logged in the patient's permanent medical record. It can be provided virtually but only via video, not telephone.

4What Your Clinical Note Must Show

1Recording Requirements

Physicians must record the duration and details of the assessment in the patient's medical records.

Start and end times of the assessment
Full relevant history and physical examination details

5Weak vs. Strong Note Examples

The strong note provides a comprehensive history and examination details, whereas the weak note lacks specifics and completeness.

❌ Weak Note

Patient re-assessed, flap observed.

✓ Strong Note

Re-assessment of patient focused on flap condition.

Full relevant history taken with a detailed physical examination conducted.

Examined graft area for infection signs
Documented patient's response to post-op care measures

6Common Reasons This Code Is Missed

Incomplete Documentation

Failing to record adequate details of the examination can result in billing denial.

Exceeding Frequency Limits

Submitting more than the allowed number of re-assessments without proper justification.

Misinterpreting Virtual Care Options

Attempting to bill for telephone assessments which are not covered under C084.

Document C084 correctly — every time

Empathia's templates automatically structure your notes to capture every required element for audit-proof billing.

Try Free Template Book a Demo

8Frequently Asked Questions

What is the fee for C084?

C084 is billed at a flat fee of CAD 34.90.

How many times can C084 be billed per patient?

C084 can be billed twice per patient per physician within a consecutive 12-month period, except for hospital admissions.

What conditions typically require re-assessment in Plastic Surgery?

Conditions like flap viability or complex wound monitoring often necessitate C084 re-assessment.

How is a specific re-assessment different from a special surgical consultation?

The re-assessment focuses on follow-up observations, whereas a consultation involves in-depth discussion of surgical plans.

What clinical scenarios require specific re-assessment for a hospital in-patient?

Patients with complex grafts or flaps post-surgery often require specific re-assessment during their hospital stay.

Can C084 be billed if the exam is conducted via telephone?

No, C084 can only be billed if the examination is conducted via video, not by telephone.

What documentation is required for billing C084?

A full, relevant history, physical examination details, and time duration must be documented in patient records.

Disclaimer: This article is intended as a general educational resource for physicians and billing staff. It does not constitute billing advice or a definitive interpretation of the OHIP Schedule of Benefits. Always verify current billing codes, eligibility criteria, and documentation requirements directly against the official Schedule of Benefits or consult with a qualified medical billing specialist.

C084 OHIP Billing Code: Efficient Management for Plastic Surgery Re-Assessments

1What Is the C084 OHIP Code?

2Related Codes

3Eligibility Requirements

4What Your Clinical Note Must Show

5Weak vs. Strong Note Examples

6Common Reasons This Code Is Missed

8Frequently Asked Questions