A600 – Comprehensive cardiology consultation
OHIP General Listings Code — CONSULTATIONS AND VISITS · Schedule of Benefits
This service is a consultation rendered by a specialist in cardiology 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.
When to Use
- When a patient requires a detailed assessment for complex arrhythmias or valvular heart disease, necessitating a minimum of 75 minutes of direct physician-patient contact.
- For a new patient referral with suspected hypertrophic cardiomyopathy, where a thorough history, physical, review of prior investigations, and discussion of management options will exceed 75 minutes.
- When managing a patient with advanced heart failure requiring optimization of multiple medications and devices, and the physician spends over 75 minutes in direct consultation to address all aspects of their condition.
Common Pitfalls
- Billing A600 when the direct patient contact time is less than the required 75 minutes, leading to claim rejection or adjustment.
- Failing to exclude time spent performing procedures or other separately billable services from the 75-minute direct contact requirement.
- Not documenting the exact start and stop times of the direct patient encounter in the medical record, which is a frequent audit finding.
Billing Tips
- Ensure the written report sent to the referring provider includes a clear statement of the minimum 75 minutes of direct patient contact.
- Verify that the patient has not received a comprehensive cardiology consultation (A600) from the same physician for the same diagnosis within the preceding 12 months, unless specific exceptions apply.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Medical
Consultations
Requires a written request from a referring physician, nurse practitioner, or dental surgeon (for hospital-based dental procedures).
The consultant must spend a minimum of 75 minutes in direct contact with the patient.
The start and stop times of the direct contact 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.
The consultant must perform a general, specific, or medical specific assessment, including a review of all relevant data.
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 time also excludes non-patient-facing time such as time spent reviewing charts, imaging, or documentation, etc.
Age-based fee premiums () apply to this code for patients under 16 years of age.
Special visit premiums (-) may be applicable if the criteria for a non-elective visit or sacrifice of office hours are met.
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