< Billing codes

Billing code

C419A — Gastroenterology hospital subsequent visit – after week 13

Gastroenterology hospital visit, week 14+

Bill for a gastroenterologist's routine hospital visit after the 13th week of admission.

Watch for: Maximum 6 per patient per month; bill an extra visit for an acute intercurrent illness as C121 instead.

Code

C419A

Description

Gastroenterology hospital subsequent visit – after week 13

FHO+ basket

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

Effective date

Apr 1, 2026

Termination date

No end date

Explanation

Updated October 26, 2026

A routine in-patient follow-up visit by a gastroenterologist after the thirteenth week of admission, up to 6 per month.

What it covers

Subsequent visits are routine hospital assessments after the admission assessment (GP43). C419 covers visits after the thirteenth week (A106).

Assessments for an acute intercurrent illness beyond the monthly limit are billed as C121 (GP43).

Billing rules

• Maximum 6 per patient per month; extras are not payable (A106, GP43).
• C121 covers visits for an acute intercurrent illness above the limit; the monthly limit doesn't apply to C121 (GP43).
• If the patient was referred to you in hospital, the date you first assessed them is the 'admission date' for choosing the code; if care was transferred, count from the actual admission date (GP43).
• As MRP, add E083 (+30%), or E084 (+45%) on Saturdays, Sundays and holidays; one per patient per day (GP47).
• Not on the Appendix J virtual care lists (Appendix J AJ1–AJ2).

Often billed with

• E083 or E084 MRP premium when you are the MRP (GP47).

Common rejections

• AM1: OHIP describes this as 'Service Limit Exceeded': more than 6 visits for the patient in the month (A106, GP43).

Related codes: C412, C417, C121, C418, E083, E084

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Gastroenterology (41), page A106.

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