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A405
A405 – Limited consultation
OHIP Consultations and Visits Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Levels of this visit
The A40x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.
- $94.75
A405 Limited consultation(this code)
A limited consultation rendered by a specialist in Community Medicine (05).
- $270.60
A400 Comprehensive community medicine consultation
A consultation rendered by a specialist in community medicine who provides all the appropriate elements of a consultation and spends a minimum of 75 minutes in direct contact with…
A limited consultation rendered by a specialist in Community Medicine (05).
Definition
A limited consultation is a consultation which is less demanding and, in terms of time, normally requires substantially less of the physician's time than the full consultation. Otherwise, a limited consultation has the same requirements as a full consultation.
Consultation Requirements
A consultation is an assessment rendered following a written request from a referring practitioner (physician, nurse practitioner, or dental surgeon for an insured hospital dental procedure) who, in light of his/her professional knowledge of the patient, requests the opinion of a physician (the 'consultant physician') competent to give advice in this field because of the complexity, seriousness, or obscurity of the case, or because another opinion is requested by the patient or patient's representative.
The service includes all work necessary for the consultant to prepare a written report with findings, opinions, and recommendations for the referring practitioner. The following are additional requirements:
• 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.
• The request must identify the consultant by name, the referring physician, nurse practitioner or dental surgeon by name and billing number, and the patient by name and health number.
• The written request sets out the information relevant to the referral and specifies the service(s) required.
Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon
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.
A consultation includes the services necessary to enable the consultant to prepare a written report (including findings, opinions, and recommendations) to the referring physician, nurse practitioner or dental surgeon.
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