C665 OHIP Billing Code: Streamlined Prenatal Consultation for Neonatal Assessment

The C665 billing code is designated for prenatal consultations performed by pediatricians while the mother is a hospital inpatient. This consultation type is crucial when expecting mothers experience complications such as preterm labor, severe pre-eclampsia, or fetal anomalies that require a neonatal team to discuss the delivery plan and immediate neonatal care.

Given its in-hospital provision, this service is pivotal for early intervention and planning in complex prenatal scenarios. It enables pediatricians to counsel parents and prepare for potential outcomes during delivery, ensuring seamless coordination among healthcare providers.

Physicians often miss billing for this code due to overlooking the specific setting requirements or confusing it with non-inpatient consultations. Accurate documentation and awareness of eligibility are vital to ensure correct billing.

Eligibility for billing C665 requires the physician to provide the prenatal consultation while the expectant mother is an inpatient in the hospital or an emergency department setting. The code can be billed once every two consecutive 12-month periods per patient, or twice within the same period if the second consultation occurs 12 to 24 months after the first in a hospital, or if a clearly unrelated diagnosis arises.

Note that the C665 service can be delivered virtually through video conferencing, billed as C665A, but is not eligible for telephone consultations.