1What Is the C173 OHIP Code?
C173 is a billing code used by vascular surgeons for specific assessments of hospital in-patients in Ontario, Canada. This type of assessment is focused, often addressing issues such as a threatened limb, graft or access site concerns, or new bruits, rather than performing a comprehensive evaluation.
A specific assessment requires a thorough history of the presenting complaint and a detailed examination of the affected parts, regions, or systems. This is crucial in formulating an accurate diagnosis, excluding potential diseases, or assessing function.
Physicians often miss billing C173 due to misunderstandings about eligibility or incorrectly identifying the nature of the assessment as not being sufficiently distinct from other assessment types. Consistently recording and documenting the time and specifics of the assessment can help ensure it is billed correctly.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A173 | A173 Specific assessment | n/a | Similar service to C173 but provided outside hospital in-patient settings. |
| C174 | C174 Specific re-assessment | n/a | Follows up on an initial specific assessment within the same specialty. |
| A174 | A174 Partial assessment | n/a | A more limited assessment in scope compared to C173. |
| A935 | A935 Special surgical consultation | n/a | In-depth consultation, often involving complex cases requiring specialist surgical input. |
3Eligibility Requirements
The C173 code is applicable for specific assessments performed by vascular surgeons in a non-emergency hospital in-patient setting. It may be billed only once per patient per physician in a 12-month period unless the patient presents a second time with a new, unrelated diagnosis. In the case of a medical specific assessment, a second assessment can be billed if at least 90 days have elapsed and the second assessment is for a hospital admission.
Services under C173 are allowed to be conducted virtually via video, not by telephone, and billed as C173A. For emergency calls or special visits, alternative codes from the General Listings and Premiums are used.
4What Your Clinical Note Must Show
Accurate documentation of time is critical for billing.
- Record the start and end time of the service.
- Ensure these times are entered into the patient's permanent medical record.
Include comprehensive details of the assessment.
- Document the full history of the presenting complaint.
- Include a detailed examination of the affected region(s) or system(s).
5Weak vs. Strong Note Examples
The strong note succeeds because it provides a comprehensive description of the assessment, including the patient's history, details of the examination, and planned follow-up actions, whereas the weak note lacks specificity and depth.
Assessed patient for vascular issue. Plan discussed.
Performed specific assessment for suspected vascular compromise in left leg.
- Documented full history of presenting complaint.
- Completed detailed examination of the left leg's vascular system.
- Plan to monitor and potentially intervene if condition worsens.
