A346 – Repeat Consultation
OHIP General Listings Code — Radiation Oncology (34) · 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 A346 when a patient returns for the same presenting problem after seeing another physician (e.g., a GP referred to a radiation oncologist, then saw a medical oncologist, and is now returning to the radiation oncologist for the original problem).
- Use A346 if the patient was initially seen by a consultant, then received care from another physician for the same issue, and now requires a follow-up consultation with the original consultant.
- A346 is appropriate when a patient requires a second consultation for the same issue, and the interval between the initial consultation and the repeat consultation included care from a different physician.
Common Pitfalls
- Billing A346 without documented intervening care by another physician will result in payment adjustment to a lesser assessment fee.
- Submitting A346 when the patient has not seen another physician since the initial consultation will lead to rejection or payment adjustment, as it does not meet the 'repeat' criteria.
- Failure to include a new written request from the referring physician, NP, or dental surgeon for the repeat consultation can lead to claim rejection.
Billing Tips
- Ensure the 'intervening care' by another physician is clearly documented in the patient's chart to support the A346 billing.
- When billing A346, confirm that the presenting problem is identical to the initial consultation; a new problem would require a new consultation code (e.g., A345).
Effective: June 1, 2025
Consultations and Visits
Radiation Oncology (34)
Radiation Oncology
Consultation
A new written request from a referring physician, nurse practitioner, or dental surgeon is required.
The request must identify 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 consultant is required to perform a general, specific or medical specific assessment, including a review of all relevant data.
A written report (including findings, opinions, and recommendations) 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.
A repeat consultation is specifically for the same presenting problem as the initial consultation.
The 'intervening care' by another physician is a mandatory condition for billing A346 instead of a standard consultation or assessment.
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