A046 – Repeat Consultation
OHIP General Listings Code — Neurosurgery (04) · Schedule of Benefits
A repeat consultation is an additional consultation rendered by the same consultant, in respect of the same presenting problem, following care rendered to the patient by another physician in the interval following the initial consultation but preceding the repeat consultation.
When to Use
- Bill A046 when a patient is referred back to you for the same neurological issue after seeing another physician (e.g., a GP managed a post-operative complication, then referred back for your assessment).
- Use A046 if a patient initially saw you for a complex headache, was managed by their family doctor for a month with new medications, and you are now seeing them again for the same headache issue.
- A046 is appropriate when a patient sees another specialist for the same presenting problem between your initial consultation and your follow-up assessment.
Common Pitfalls
- Billing A046 when the patient was not seen by another physician in the interval; this scenario requires A045 (Consultation).
- Failing to obtain a new, separate referral request from the referring physician for the repeat consultation, which can lead to payment adjustment.
- Using A046 for a direct follow-up appointment without an intervening physician's care; this should be billed as an assessment code (e.g., A043, A044).
Billing Tips
- Ensure the new referral for A046 clearly states the patient was seen by another physician for the same problem since your last consultation.
- Retain documentation of the intervening physician's care in your records to support the A046 claim if audited.
Effective: June 1, 2025
Consultations and Visits
Neurosurgery (04)
Consultations and Visits
Consultation
A copy of the written request for the consultation, signed by the referring physician, nurse practitioner or dental surgeon must be kept in the consulting physician’s medical record, except in the case of a consultation which occurs in a hospital, long-term care institution or multi-specialty clinic where common medical records are maintained. In such cases, the written request may be contained on the common medical record.
The request identifies the consultant by name and/or the specialty being consulted, the referring physician, nurse practitioner or dental surgeon by name and billing number, and identifies the patient by name and health number.
The written request sets out the information relevant to the referral and specifies the service(s) required.
A consultation includes the services necessary to enable the consultant to prepare a written report (including findings, opinions, and recommendations) to the referring physician, nurse practitioner or dental surgeon. Where the referral is made by a nurse practitioner, the consultant shall provide the report to the nurse practitioner and the patient’s primary care provider, if applicable.
Except where otherwise specified, the consultant is required to perform a general, specific or medical specific assessment, including a review of all relevant data.
A repeat consultation is specifically for cases where another physician has provided care for the same problem in the interval between the initial and repeat consultation.
For emergency calls or special visits in LTC settings, refer to Special Visit Premiums ( to ).
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