A150 – Comprehensive endocrinology consultation
OHIP General Listings Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A consultation rendered by a specialist in endocrinology who provides all the appropriate elements of a consultation and spends a minimum of seventy-five (75) minutes in direct contact with the patient, exclusive of time spent rendering any other separately billable intervention to the patient.
When to Use
- When managing a patient with a complex, undiagnosed endocrine disorder requiring extensive history, physical examination, and review of multiple investigations over a minimum of 75 minutes.
- For a new patient referral presenting with multiple, interconnected endocrine issues (e.g., pituitary dysfunction, adrenal insufficiency, and diabetes mellitus) that necessitate a comprehensive assessment.
- When a patient requires a detailed reassessment of a previously diagnosed complex endocrine condition, involving significant time for reviewing new data and adjusting management, and it has been more than 24 months since the last A150 for the same diagnosis.
Common Pitfalls
- Billing A150 when the direct patient contact time is less than 75 minutes, which will result in the claim being adjusted to a lesser assessment fee like A155.
- Failing to document the start and stop times of the patient encounter in the medical record, a mandatory requirement for this code.
- Submitting A150 for a patient who has already received a comprehensive endocrinology consultation (A150) for the same diagnosis within the preceding 12 months, unless specific exceptions apply.
Billing Tips
- Ensure the referral request clearly outlines the specific endocrine concerns and the services required, and retain a copy in the patient's chart.
- Verify that the patient's condition warrants the extensive time commitment; A150 is not appropriate for routine follow-ups or simple endocrine management.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Consultations and Visits
Consultation
Must satisfy all elements of a consultation as defined in the General Preamble ().
Minimum of 75 minutes in direct contact with the patient.
Start and stop times must be recorded in the patient's permanent medical record.
A written report must be sent to the referring physician, nurse practitioner, or dental surgeon.
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.
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