1What Is the C675 OHIP Code?
Understanding the C675 OHIP Code
The C675 code is used by cardiologists to bill for limited consultations concerning hospital in-patients. This service is often required when there's a need to address a specific cardiac concern, such as evaluating pre-operative risk or deciding on treatment for an arrhythmia prior to discharge. Unlike comprehensive consultations, this code is intended for situations where a full cardiovascular assessment is not necessary, focusing instead on targeted clinical questions.
This code might be overlooked due to misconceptions about the requirements for a consultation or a lack of awareness that focused cardiac inquiries can be billed separately. Proper documentation of the clinical question and rationale for the consultation is essential to ensure compliance and appropriate reimbursement.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A600 | Comprehensive cardiology consultation | As per circumstances, no specific limit unless otherwise specified | Used for a full cardiovascular assessment in a hospital setting. |
| A605 | Consultation | As per circumstances, no specific limit unless otherwise specified | Applies to general consultation settings within cardiology. |
| A606 | Repeat consultation | As per circumstances, no specific limit unless otherwise specified | For situations requiring a follow-up consultation after the initial full consultation. |
| A675 | Limited consultation | Matches C675 but for outpatient | Applicable to the same service provided outside hospital in-patient settings. |
3Eligibility Requirements
Eligibility Requirements for C675
-
Consultation Setting: This code is applicable for limited cardiology consultations while a patient is in a hospital setting as an in-patient.
-
Virtual Delivery: C675 may be rendered as a virtual service via video, billed as C675A. Telephone consultations do not qualify as a Comprehensive Virtual Care Service under this code.
-
Frequency Restrictions:
- One service is allowed per two consecutive 12-month periods for the same patient, physician, and diagnosis.
- One service every 12 months for a different, clearly defined, unrelated diagnosis.
-
Submission Instructions:
- Use diagnostic code 428 when submitting claims.
- For emergency or out-patient scenarios where the physician is not on duty in an emergency department, refer to the General Listings.
4What Your Clinical Note Must Show
Comprehensive clinical records must detail the focus of the consultation.
- Specific cardiac question prompting the consultation.
- Assessment and recommendations made during the consultation.
- Explicit documentation if the consultation is conducted via virtual video.
5Weak vs. Strong Note Examples
The strong note succeeds by clearly defining the specific cardiac issue, the assessment made, and actionable recommendations, while the weak note lacks specificity and context.
Patient seen for cardiac evaluation. Discussed treatment options.
Patient admitted for hip surgery; consultation requested to assess cardiac risk.
Pre-operative evaluation focused on recently diagnosed atrial fibrillation.
Recommendations included anticoagulation evaluation and rhythm monitoring before proceeding with surgery.
- Specific inquiry focus
- Clear assessment results
- Recommendations for further management
