1What Is the C614 OHIP Code?
What is C614?
C614 is an OHIP billing code used by hematologists for specific medical re-assessments of non-emergency hospital in-patients in Ontario. These re-assessments involve a comprehensive review of a patient's condition, focused on hematological issues.
In a typical clinical setting, C614 is billed when a hematologist reviews a patient after a transfusion or reassesses an anticoagulation plan due to changes in renal function or bleeding risk. This targeted approach reinforces the hematologist’s role in managing complex in-patient care cases.
Physicians may overlook billing for C614 due to restrictions on frequency or failure to document the minimum time spent. Ensuring accurate documentation and understanding eligibility criteria prevents missed billing opportunities.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A613 | Medical specific assessment | As required | Used in hospital for a full hematological assessment. |
| C613 | Medical specific assessment | As required | Specifically for initial assessment in a hematological hospital setting. |
| A611 | Complex medical specific re-assessment | As required | For complex re-assessments requiring more detailed evaluation than C614. |
| A614 | Medical specific re-assessment | As required | For the same service provided in an out-patient setting. |
3Eligibility Requirements
Eligibility Requirements
- Setting: C614 applies in non-emergency hospital in-patient services within hematology.
- Virtual Delivery: Eligible for virtual care, billed as C614A, when conducted via video; telephone consultations are not covered.
- Re-assessment Criteria: Requires a full, relevant history and physical examination of one or more body systems.
- Frequency Limit: Limited to two per patient per physician per 12 months unless for hospital admissions. Excess is adjusted to a lesser fee.
- Time Documentation: Record the start and end times of the assessment in the patient's medical records.
4What Your Clinical Note Must Show
Ensure the following documentation exists to support billing C614:
- Full, relevant patient history related to the hematological issue.
- Comprehensive physical examination notes.
- Time logs indicating when the assessment started and ended.
5Weak vs. Strong Note Examples
The strong note includes detailed clinical information, changed plans based on assessment findings, and accurately logs time, whereas the weak note lacks detail and time stamping.
Patient reviewed post-transfusion. Plan unchanged.
Reviewed patient following transfusion for anemia.
Conducted focused examination on hematology system, updated relevant history.
Changed anticoagulation plan due to improved renal function.
- Start time: 14:00
- End time: 14:30
