C770 OHIP Billing Code: Comprehensive Geriatric Consultation Guidance

What is the C770 Code?

The C770 billing code is designated for an extended comprehensive geriatric consultation performed by a physician with special competence in geriatrics in Ontario, Canada. This code covers a detailed examination of elderly patients who are at least 65 years of age or specifically require dementia assessments. The consultation requires a minimum of 90 minutes of direct contact with the patient in a hospital in-patient setting.

This code is often utilized for patients admitted after incidents such as falls or when presenting with symptoms like delirium. A comprehensive assessment including functional, cognitive, and medication reviews is essential to assist in discharge planning and ensure the patient's holistic needs are addressed.

Physicians frequently miss billing C770 due to misunderstandings about eligibility criteria or the requirement for detailed documentation, especially the start and stop times of the service.

Eligibility Requirements

• Patient Criteria: At least 65 years of age, or consultation specifically for assessing dementia.
• Consultation Requirements: Must be performed by a physician with a certification in geriatrics.
• Setting: Conducted as a non-emergency hospital in-patient service.
• Contact Time: Minimum of 90 minutes of direct patient contact, not including times spent on other separately billable interventions.
• Frequency:
  • One service per two consecutive 12-month periods for the same patient, diagnosis, and physician.
  • Two services in the same period if the second is for a hospital in-patient or ED patient between 12-24 months after the first.
  • One service every 12 months for unrelated diagnoses.
• Documentation: Start and stop times must be recorded in the patient's permanent medical record.