A356 – Repeat Consultation
OHIP General Listings Code — Urology (35) · Schedule of Benefits
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 A356 when a urologist has previously seen a patient for a specific urological issue (e.g., recurrent kidney stones), the patient was then managed by their GP for a period, and the GP refers the patient back for a repeat opinion on the same issue.
- Use A356 if a patient saw you for a complex bladder dysfunction, was subsequently managed by another specialist for a different but related issue, and now requires your re-evaluation for the original bladder problem.
- A356 is appropriate when a patient's prostate cancer follow-up requires a new consultation after an interval where they received treatment from an oncologist, and the oncologist has referred them back for your urological assessment of the same condition.
Common Pitfalls
- Billing A356 when the patient has not received care from another physician for the same problem in the interval; this should be billed as an initial consultation (A355) or a specific assessment (A353).
- Failing to obtain a new, valid referral for the repeat consultation, especially if the interval since the last consultation is significant or the referring physician has changed.
- Submitting A356 when the consultation is for a new, unrelated problem; this requires a separate initial consultation code (A355).
Billing Tips
- Ensure the referral documentation clearly states the patient was seen by another physician in the interim for the same presenting problem, differentiating it from a simple follow-up.
- Verify that a comprehensive written report has been sent to the referring practitioner, detailing findings, opinions, and recommendations for the repeat consultation.
Effective: June 1, 2025
Consultations and Visits
Urology (35)
Urology
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.
The consultant must provide a written report (including findings, opinions, and recommendations) to the referring practitioner.
Includes a general, specific, or medical specific assessment and a review of all relevant data.
Does not include endoscopic examination.
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