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Billing code

C237A — Ophthalmology subsequent hospital visit – weeks 6 to 13

Ophthalmology hospital visit, weeks 6–13

Bill for an ophthalmologist's routine hospital visit from the 6th to the 13th week after admission.

Watch for: Maximum 3 per patient per week; bill an extra visit for an acute intercurrent illness as C121 instead.

Code

C237A

Description

Ophthalmology subsequent hospital visit – weeks 6 to 13

FHO+ basket

Not in the FHO+ base rate basket (Schedule 2 or 2B).

Effective date

Jun 1, 2025

Termination date

No end date

Explanation

Updated October 26, 2026

Routine in-patient follow-up visit by an ophthalmologist from the 6th to the 13th week after admission. Maximum 3 per patient per week.

What it covers

A routine in-patient visit by an ophthalmologist after the admission assessment, from the sixth to thirteenth week inclusive (A162, GP43).

For emergency calls and special visits to in-patients, use the general listings and premiums instead (A162).

Billing rules

• Maximum 3 per patient per week (A162, GP43).
• After 5 weeks, a visit for an acute intercurrent illness beyond the limits is C121 (GP43).
• When an in-patient is referred to you, the date you first assess them counts as the admission date. On transfer of care, count from the actual admission date (GP43).
• If you are the MRP, E083 (+30%) can be added to subsequent visits (GP47).
• Not listed in Appendix J, so not payable as a virtual service (AJ1–AJ2).

Often billed with

• E083 MRP premium when you are the most responsible physician (GP47).
• C121 for acute intercurrent illness beyond the weekly limit (GP43).

Common rejections

• AM1: Service limit exceeded: C237 is limited to 3 per patient per week (A162).

Related codes: C232, C239, C121, C238, E083

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Ophthalmology (23), page A162.

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