C667 OHIP Billing Code: Comprehensive Neurodevelopmental Consultations for Pediatric Inpatients

C667 is the billing code for neurodevelopmental consultations provided to pediatric patients while they are admitted as inpatients in a hospital. These consultations often involve assessing a child's developmental trajectory and planning for their future care based on various factors, such as history of extreme preterm birth, unprovoked seizures, or development delays undergoing investigation.

Due to the complexity and multidisciplinary nature of these consultations, they are comprehensive and require coordination among nursing staff, therapists, and physicians. The coding is distinct from A667, which is used for similar assessments in outpatient settings. Medical professionals may mistakenly use A667 instead of C667, particularly when failing to confirm the patient's inpatient status.

To be eligible for OHIP billing under C667:

• The patient must be an inpatient in a hospital during the consultation.
• Billing is limited to one service per patient, per physician for the same diagnosis, within two consecutive 12-month periods. An exception allows two services if the second occurs more than 12 months but less than 24 months after the first, for hospital inpatients or Emergency Department settings.
• For different diagnoses, the service is allowed once every 12 months.
• C667 is available for virtual delivery via video only, as specified in Appendix J, Section 1.

For all services, the start and stop times must be recorded in the patient’s permanent medical record; otherwise, payment defaults to a general or specific assessment rate.