1What Is the C093 OHIP Code?
C093 is a specific assessment billing code under OHIP for cardiac surgical evaluations of hospital in-patients. This service is provided by cardiac specialists and requires a comprehensive examination related to cardiac conditions such as sternal wound concerns post-surgery, new murmurs in patients with prosthetic valves, or assessments for pericardial collections.
This code is critical for surgeons to make accurate diagnoses, evaluate the necessity for further surgical interventions, and ensure optimal patient care. An oversight in billing could occur if the assessment is mistaken for general consultations or if documentation fails to reflect the specificity required for this comprehensive cardiac evaluation.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A093 | Specific assessment | One per patient per physician per 12 months | Out-patient equivalent for specific assessments in cardiac surgery. |
| C094 | Specific re-assessment | One per patient per physician per 12 months | Re-assessment for ongoing cardiac surgical concerns. |
| A094 | Partial assessment | As needed | Assessment with a less comprehensive scope in cardiac surgery. |
| A935 | Special surgical consultation | As clinically required | Comprehensive consultation for complex cardiac surgical cases. |
3Eligibility Requirements
The C093 code can be used when performing a specific assessment within a non-emergency hospital in-patient setting. Specialists in cardiac surgery conduct this examination to address precise cardiac issues. According to OHIP guidelines, the frequency of specific assessments is limited to one per patient, per physician, within a twelve-month period. Exceptions to this limit permit a second assessment in cases with a distinctly different diagnosis unconnected to the initial assessment, or if at least 90 days have passed and the assessment involves a hospital admission.
For virtual care services, C093 is only eligible when conducted via video, and not through telephone consultations.
4What Your Clinical Note Must Show
Specific assessment must include a thorough record of:
- Start and end time of the service.
- Full history of the presenting cardiac complaint.
- Detailed examination of relevant cardiac areas to establish a diagnosis or assess function.
5Weak vs. Strong Note Examples
The strong note provides a detailed clinical picture and records specific actions taken related to cardiac surgery concerns, while the weak note lacks detail and misses critical assessment components.
Patient presented with chest pain. Assessed general health and reviewed medical history. No major issues noted.
Conducted a detailed assessment on patient with a post-surgical sternal wound concern. Reviewed detailed history of the cardiac procedure and conducted a thorough examination of sternal area.
Confirmed assessment to evaluate for potential infection with differential diagnosis considerations. Noted plan to monitor wound progression and scheduled follow-up review.
- Documented time: 10:00 - 10:45.
- Comprehensive examination of the sternal wound area included.
