A605 – Cardiology Consultation
OHIP General Listings Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A consultation rendered by a specialist in cardiology following a written request from a referring physician, nurse practitioner, or dental surgeon. The service includes the necessary assessment and review of data to provide a written report back to the referrer.
When to Use
- Bill A605 when a cardiologist performs a new patient assessment for a suspected cardiac condition (e.g., new onset chest pain, palpitations) based on a referral from a family physician or NP.
- Use A605 for a cardiology consultation requested by a dentist for a patient undergoing a complex dental procedure requiring cardiac clearance.
- A605 is appropriate when a cardiologist reviews diagnostic data (e.g., ECG, Holter) and provides a written assessment and recommendations to the referring provider for a patient not currently admitted to hospital.
Common Pitfalls
- Billing A605 when the patient is already an inpatient under your care; use C605 (In-patient cardiology consultation) instead.
- Submitting A605 without a clear written referral from the requesting provider, which is a mandatory requirement.
- Failing to send a written report back to the referring physician, NP, or dental surgeon; this is a required component of the A605 service.
Billing Tips
- Ensure the referral request for A605 clearly states the patient's health number, the referring provider's name and billing number, and the specific cardiac concern.
- Remember that A605 is limited to one service per diagnosis per two years by the same physician, so avoid billing it for routine follow-up care that might be better billed as an assessment (e.g., A007) or a limited consultation (A675).
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Professional
Consultation
A written request from a referring physician, nurse practitioner, or dental surgeon (for hospital-based dental procedures) is mandatory.
A written report containing 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 medical record must contain a copy of the signed written request (except in hospitals/clinics with common records).
The request must identify 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.
If the physician is in the hospital but not on duty in the emergency department, A605 should be used for patients seen in the ED or OPD.
Age-based fee premiums apply for patients under 16 years of age ().
For services not specifically listed in the Cardiology section, refer to the Internal Medicine section.
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