1What Is the C720 OHIP Code?
The C720 billing code refers to a Comprehensive Occupational Medicine Consultation provided to hospital in-patients. This service is meant for patients whose illnesses are being assessed for occupational causes or who require planning for their return to work while admitted.
Comprehensive consultations under this code require a minimum of 75 minutes spent in direct patient contact. The code is intended for complex cases requiring a specialist's evaluation and recommendations before discharging a patient back to their work environment.
Physicians can often overlook billing C720 due to its specific requirements regarding patient settings and time documentation, leading to adjustments to lesser paying fees if not correctly adhered to.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A720 | Comprehensive occupational medicine consultation | One service per two consecutive 12-month periods | Equivalent service for outside hospital in-patient settings. |
| A725 | Consultation | No frequency restrictions mentioned | A general consultation under Occupational Medicine. |
| A726 | Repeat consultation | As required under repeating circumstances | Used for follow-up consultations. |
| A925 | Limited consultation | No frequency restrictions mentioned | A shorter, less comprehensive consultation. |
3Eligibility Requirements
Eligibility Requirements for C720
To be eligible for C720 billing:
- The consultation must be provided by a specialist in occupational medicine to an in-patient in a non-emergency hospital setting.
- The physician must spend a minimum of 75 minutes in direct contact with the patient.
- A comprehensive consultation includes a full assessment and preparation of a report with findings and recommendations related to the occupational aspect of the patient's condition.
- The service is billable only once per two consecutive 12-month periods per patient per physician per diagnosis, unless the service qualifies for increased frequency as specified (e.g., hospital inpatient or ER settings).
- The C720 can also be rendered as C720A for virtual care, but only through video consultation.
4What Your Clinical Note Must Show
Ensure time documentation is rigorous.
- Record start and stop times in the patient's permanent medical record.
- Verify 75 minutes of direct patient contact is met.
A thorough report must be prepared and filed.
- Include findings, opinions, and recommendations.
- Provide report to the referring healthcare provider.
Maintain a copy of the consultation request.
- Store referral request signed by the referring provider.
- Identify both the consultant and referrer name and billing numbers.
5Weak vs. Strong Note Examples
The strong note succeeds because it details the consultation length and key elements discussed, ensuring compliance with billing requirements.
Patient seen for comprehensive consultation. Various occupational factors considered.
Consultation involved detailed occupational assessment, lasting 80 minutes. Diagnostic focus on work-related musculoskeletal issues.
- Start time: 09:00 AM, End time: 10:20 AM.
- Report sent to referring physician with detailed findings and return-to-work recommendations.
