A176 – Repeat consultation
OHIP General Listings Code — CONSULTATIONS AND VISITS · 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 A176 when a patient returns for the same vascular issue after being managed by a different physician (e.g., GP, another specialist) for a period, and a new referral is received.
- Use A176 if the patient was seen by another physician for the same presenting problem between the initial consultation (A175) and this subsequent visit, and a new request is obtained.
- A176 is appropriate when a consultant provides a repeat assessment for the same vascular condition, following an interval where the patient received care from a different provider, provided a new written request is on file.
Common Pitfalls
- Billing A176 without a new, valid written request from the referring provider for each instance will result in payment adjustment to a lesser assessment fee (e.g., A173, A174).
- Failure to prepare and submit a written report to the referring provider when billing A176 can lead to payment adjustments.
- Submitting A176 when the patient has not been seen by another physician in the interval, or if the same consultant provided continuous care, is incorrect; A175 would be the appropriate code.
Billing Tips
- Ensure the written request for A176 clearly identifies the consultant, referring provider (name and OHIP billing number), and patient (name and health number).
- For virtual repeat consultations, append 'A' to the code (A176A) and confirm the service was conducted via video, as per Appendix J.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Vascular Surgery (17)
Consultation
A repeat consultation is specifically for cases where the patient was managed by another physician between the initial consultation and the current visit for the same problem.
If the consultant requests the referring provider to submit a referral after the service has already been provided, the service is not payable as a consultation.
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