1What Is the C713 OHIP Code?
What is OHIP Billing Code C713?
OHIP Billing Code C713 applies to medical specific assessments performed by critical care specialists on hospital in-patients outside a critical care area. This typically involves assessing a deteriorating patient as requested by the ward team to determine whether a transfer to a critical care unit is needed.
Medical specific assessments require a comprehensive clinical examination and analysis to diagnose, exclude diseases, or assess function. Due to the specific criteria and thorough documentation required, it is common for such assessments to be underbilled or miscoded unless meticulous standards are maintained.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A713 | Medical specific assessment | Limited to one per patient per physician per 12 months; settings differ | Same assessment rendered outside hospital in-patient settings. |
| A111 | Complex medical specific re-assessment | Re-assessment services, frequency as per complex cases | Complex cases in the Critical Care Medicine listings. |
| A114 | Medical specific re-assessment | Re-assessment services, frequency as per standard cases | Standard re-assessment under Critical Care listings. |
| C111 | Complex medical specific re-assessment | Re-assessment services, frequency as per complex cases | In-patient complex re-assessment in Critical Care listings. |
3Eligibility Requirements
Eligibility Requirements for C713
- Setting: Provided for non-emergency hospital in-patient services under the Critical Care Medicine listing.
- Frequency: Limited to one per patient per physician per 12-month period, unless the patient presents with a different diagnosis or, for hospital admission assessments, at least 90 days have elapsed.
- Virtual Services: Eligible for virtual delivery via video (C713A), but not by telephone.
- Documentation: Services are not payable without recording the start and end times in the patient's medical record.
4What Your Clinical Note Must Show
Service is not payable without time recording.
- Record the start and end time of the service on the patient's medical record.
Must conduct a full history and detailed examination.
- Include comprehensive notes on the presenting complaint and affected areas.
5Weak vs. Strong Note Examples
The strong note includes comprehensive documentation of time, history, and examination details, whereas the weak note lacks specificity and necessary documentation.
Patient assessment completed.
No detailed history or examination area provided.
Completed medical specific assessment at 14:00; concluded at 14:45.
Thorough history taken: patient experiencing respiratory complications post-surgery.
Detailed examination of respiratory system conducted to rule out infection.
- Time stamped correctly in the patient record
- Comprehensive history of presenting complaint
- Detailed examination findings documented
