1What Is the C661 OHIP Code?
C661 represents the Complex Medical Specific Re-assessment in pediatrics for hospital in-patients. This code is applicable when reassessing a child with multiple active, interacting health problems, requiring a comprehensive review.
In a typical setting, pediatric patients with complex chronic conditions are admitted, and during their stay, require thorough reassessment of various health issues collectively rather than addressing isolated problems.
This code is often missed due to misinterpreting the complexity of the case, or failing to document the interactions of multiple conditions comprehensively in the patient's record.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A263 | Medical specific assessment | As per specialty listing | Used for medical assessments; related to pediatric cases, $95.75. |
| C263 | Medical specific assessment | As per specialty listing | Hospital-specific assessment for pediatrics, $95.75. |
| A264 | Medical specific re-assessment | As per specialty listing | Re-assessment in a pediatric context, less complex than C661, $70.75. |
| A661 | Complex medical specific re-assessment | As per specialty listing | For complex re-assessments similar to C661 but outside of the hospital inpatient setting, $86.35. |
3Eligibility Requirements
The C661 code is eligible for use in specific circumstances based on the OHIP Schedule of Benefits:
- Setting: Reassessment must occur for a hospital in-patient.
- Delivery Method: Can be billed as C661A for virtual services, but only through video; telephone services are not eligible.
- Alternative Code: For equivalent service provided outside the hospital setting, the corresponding code is A661.
Ensure that documentation supports the complexity and interaction of multiple active problems requiring reassessment.
4What Your Clinical Note Must Show
Ensure the following are clearly documented for C661 billing.
- Patient's active problems and their interactions.
- Complexity of the reassessment process.
- Rationale for choosing complex re-assessment over standard assessment codes.
- Details of virtual consultation (if applicable), specifying video modality.
5Weak vs. Strong Note Examples
The strong note succeeds by detailing the complexity and interactions between multiple conditions, while the weak note provides insufficient information.
Reviewed patient's condition. Reassessment completed.
Comprehensive reassessment conducted on pediatric patient admitted with multiple active problems including asthma, diabetes, and hypertension.
- Asthma management requires adjustment due to increased bronchial activity.
- Diabetes monitoring indicates necessary changes in insulin dosage.
- Hypertension is interacting with other conditions, necessitating a comprehensive medication review.
