A070 – Geriatric consultation
OHIP General Listings Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A consultation rendered by a geriatrician (specialty 07) in association with a special visit to a hospital in-patient, long-term care in-patient, or emergency department patient. This code is specifically designed to be billed when the consultation occurs during a non-elective special visit to these settings.
When to Use
- Bill A070 when a geriatrician performs a consultation during a non-elective, urgent special visit to a hospital inpatient who requires immediate geriatric assessment.
- Use A070 for a geriatrician's consultation during a non-elective special visit to a long-term care resident presenting with an acute change in condition, necessitating immediate specialist input.
- A070 is appropriate for a geriatrician's consultation during a non-elective special visit to an emergency department patient with complex geriatric needs that cannot be managed by the ED physician alone.
Common Pitfalls
- Claims for A070 may be rejected if the written report to the referring provider is missing or incomplete, failing to include findings, opinions, and recommendations.
- Billing A070 for a routine hospital round or an elective admission assessment will result in rejection, as it specifically requires a non-elective special visit.
- Failure to obtain a written request from the referring physician, nurse practitioner, or dental surgeon prior to the consultation will lead to claim adjustment or rejection for A070.
Billing Tips
- Ensure the claim for A070 includes the correct corresponding special visit premium (C-prefix for hospital, W-prefix for LTC, K-prefix for ED) to reflect the non-elective nature of the visit.
- Document clearly that the consultation was part of a non-elective special visit, distinguishing it from standard consultations (A075) or comprehensive geriatric assessments (A775, A770).
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Consultations and Visits
Consultation
Requires a written request from a referring physician, nurse practitioner, or dental surgeon in connection with an insured dental procedure rendered in a hospital.
The consultant must provide a written report (including findings, opinions, and recommendations) to the referring physician, nurse practitioner or dental surgeon.
The consultant is required to perform a general, specific or medical specific assessment, including a review of all relevant data.
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.
The request would ordinarily also include appropriate clinical information, such as the reason for the referral for consultation, present and past history, physical findings and relevant test results and reports.
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