1What Is the C385 OHIP Code?
The C385 billing code represents a limited neurology consultation, aimed at providing targeted insights into specific neurological queries for hospital in-patients. Typically utilized when a narrow neurological issue arises, such as determining whether a new weakness is due to neurological causes or deconditioning, or assessing if antiepileptic drug levels are the source of confusion. It’s often overlooked that this code carries the same fee as a repeat consultation (C186), so selection should be based on the service's nature rather than service quantity. A full in-patient neurological assessment falls under code C185.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A180 | Special neurology consultation | Subject to standard consultation limits. | Used for specialized neurology consultations requiring in-depth assessment. |
| A185 | Consultation | Subject to the same consultation frequency limits. | Standard neurology consultation for comprehensive evaluations. |
| A186 | Repeat consultation | Subject to the same consultation frequency limits. | For repeat neurology consultations. |
| A385 | Limited consultation | Subject to the same consultation frequency limits. | Equivalent to C385, used in the Neurology listings. |
3Eligibility Requirements
According to OHIP’s eligibility guidelines, C385 services can be executed via video (billed as C385A) but not over the phone, and this differentiation is crucial as it impacts billing eligibility. A C385 consultation is claimable once every 12 months per distinct diagnosis or once per two consecutive 12-month periods for the same patient, physician, and diagnosis. After a periodic health visit under the Nursing Homes Act, C385 may only be claimed after 6 months.
4What Your Clinical Note Must Show
Ensure all patient details are complete.
- Patient's full name
- Health card number
- Date of birth
Document the focus of the consultation and outcomes clearly.
- Specific neurological question addressed
- Diagnosis and recommendations made
- Consultation date and duration
Adhere to virtual consultation eligibility when applicable.
- Video-only consultation confirmation
- Technical details of the video platform used
5Weak vs. Strong Note Examples
The strong note succeeds by providing a clear focus, detailed differential diagnosis, and actionable recommendations, unlike the weak note which lacks specific outcomes and clarity.
Patient assessed for new weakness. Unclear if neurological or deconditioning.
Patient presented with new weakness. Examination focused on differential diagnosis between neurological causation and deconditioning. Findings suggest neurological origin. Recommended adjustment of antiepileptic medication due to subtherapeutic levels contributing to confusion.
- Established lack of deconditioning signs.
- Communicated potential side effects of current medication to attending staff.
