1What Is the C114 OHIP Code?
Understanding C114
C114 is an OHIP billing code designed for specific re-assessments in critical care settings. Typically, this involves a focused re-examination by an intensivist on a hospital in-patient. These patients often transition from intensive care and require follow-up on specific issues such as tracheostomy weaning, sedation withdrawal, or ongoing oxygen dependency.
This code ensures that the specialist's expertise in follow-up care is properly remunerated. However, it's commonly missed due to inadequate documentation of the assessment's parameters or misinterpretation of the billing frequency limits.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A713 | Medical specific assessment | As needed | Initial assessment including comprehensive history and examination. |
| C713 | Medical specific assessment | As needed | Used for initial specific medical assessments in critical care. |
| A111 | Complex medical specific re-assessment | As needed | Re-assessment involving a higher complexity in critical care settings. |
| A114 | Medical specific re-assessment | Limited to two per patient per year | Out-patient equivalent of C114; same service outside inpatient settings. |
3Eligibility Requirements
Eligibility Requirements for C114
- Setting: Applies to non-emergency hospital in-patient services.
- Frequency: Limited to two re-assessments per patient per physician each consecutive 12-month period, except those for hospital admissions, which have no limits.
- Virtual Delivery: Eligible for video consultations only, billed as C114A. Telephone consultations do not qualify.
- Documentation: Requires comprehensive history and physical examination of one or more systems, with time of service explicitly recorded.
Refer to General Preamble GP23 and GP7 for full eligibility details.
4What Your Clinical Note Must Show
Accurate recording of time is mandatory for C114 claims.
- Start and end times of the service must be noted in the patient's medical record.
A full history and examination of relevant systems are required.
- Document the pertinent findings and clinical decisions made during the re-assessment.
5Weak vs. Strong Note Examples
The strong note succeeds by clearly documenting the specific focus of the re-assessment, the clinical decisions involved, and adheres to recording time, addressing the requirements for C114 billing.
Patient reassessed. Stable. Plan to continue monitoring.
Patient reassessed focusing on weaning from tracheostomy. Noted improvement in respiratory status. Plan to reduce sedation while monitoring oxygen levels.
- Time started: 09:00
- Time ended: 09:30
- Relevant history and system examination detailed
