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A580 – Comprehensive laboratory medicine consultation

OHIP Consultations and Visits Code — CONSULTATIONS AND VISITS · Schedule of Benefits

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Levels of this visit

The A58x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.

  • A585 Diagnostic consultation

    A diagnostic laboratory medicine consultation is the service rendered when tissue, slides, specimens and/or laboratory results prepared in one licensed laboratory are referred to…

    $106.50

  • A586 Repeat consultation

    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…

    $110.00

  • A580 Comprehensive laboratory medicine consultation(this code)

    A consultation rendered by a specialist in laboratory medicine who provides all the appropriate elements of a consultation and spends a minimum of 75 minutes in direct contact…

    $342.25
A consultation rendered by a specialist in laboratory medicine who provides all the appropriate elements of a consultation and spends a minimum of 75 minutes in direct contact with the patient, exclusive of time spent rendering any other separately billable intervention to the patient.
Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon
Must satisfy all elements of a consultation as defined in General Preamble .
Requires a written request from a referring physician, nurse practitioner, or dental surgeon.
Minimum of 75 minutes in direct contact with the patient.
Start and stop times must be recorded in the patient’s permanent medical record.
A written report (including findings, opinions, and recommendations) must be sent to the referring provider.
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.
Usage limits
Limited to one service per patient per two consecutive 12-month periods for the same diagnosis (unless the second is in-patient/ED after 12 months). Limited to one service every 12 months for a clearly defined unrelated diagnosis.
C580Comprehensive laboratory medicine consultation (In-patient)A585Diagnostic consultationA586Repeat consultationA285Consultation (Laboratory Medicine)

The calculation of time excludes time devoted to any other service or procedure for which an amount is payable in addition to the consultation.

The calculation of time excludes non-patient-facing time (e.g., chart review, imaging review, documentation).

Eligible for age-based fee premiums for patients under 16 years of age ().

Note: The SOB table on page A131 contains a typo listing the description as 'Comprehensive internal medicine consultation'; however, the heading and commentary confirm it is a Laboratory Medicine service.

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