A446 – Repeat Consultation
OHIP General Listings Code — Medical Oncology (44) · 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 A446 when a patient is referred back to you for the same presenting problem after seeing another physician, and you need to reassess their condition.
- Use A446 if the patient's initial consultation was with you (A445), and an interval physician visit occurred before your repeat assessment for the same issue.
- A446 is appropriate when a new written request is received for a follow-up assessment of a previously consulted condition, provided another physician has seen the patient since your last assessment.
Common Pitfalls
- Claiming A446 without a new, specific written request for the repeat consultation will result in payment being reduced to a lesser assessment fee.
- Billing A446 if the patient has not been seen by another physician between your initial consultation and the repeat assessment is incorrect; this scenario may warrant a different visit code.
- Failure to submit a written report to the referring provider after rendering the A446 service can lead to payment adjustments or audits.
Billing Tips
- Ensure the medical record clearly documents the interval visit by another physician, as this is a key requirement for A446 eligibility.
- Verify that the written request for the repeat consultation explicitly states it is for the same presenting problem as the initial consultation.
Effective: June 1, 2025
Consultations and Visits
Medical Oncology (44)
Professional Fee
Consultation
A written request from a referring physician, nurse practitioner, or dental surgeon is required.
A new written request is required specifically for the repeat consultation.
The consultant must prepare a written report (including findings, opinions, and recommendations) to the referring provider.
The patient must have been seen by another physician in the interval between the initial consultation and the repeat consultation.
The consultant must perform a general, specific, or medical specific assessment, including a review of all relevant data.
If consultation requirements (e.g., written request, written report) are not met, the amount payable will be reduced to a lesser assessment fee.
A copy of the written request must be kept in the consulting physician's medical record (except in hospitals or multi-specialty clinics with common records).
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