A615 – Consultation
OHIP General Listings Code — Haematology (61) · Schedule of Benefits
A consultation is an assessment rendered following a written request from a referring physician, nurse practitioner or dental surgeon who requests the opinion of a haematology specialist because of the complexity, seriousness, or obscurity of the case. The service includes the necessary elements to prepare a written report to the referrer.
When to Use
- Bill A615 when a haematologist provides a comprehensive assessment and written report for a complex case, such as diagnosing a rare bleeding disorder, following a referral from a primary care physician.
- Use A615 for a specialist opinion on managing a newly diagnosed myelodysplastic syndrome, where a detailed review of pathology and bone marrow biopsy is required, and a written report is sent to the referring oncologist.
- A615 is appropriate when a patient with a history of thrombosis requires a specialist opinion on the optimal anticoagulation strategy for a complex, recurrent event, with a formal report provided to the referring internist.
Common Pitfalls
- Billing A615 without a written request from a physician, NP, or dental surgeon is a common rejection reason; ensure this document is on file.
- Submitting A615 for a patient under 17 years of age will result in rejection, as this code has a minimum age requirement of 17.
- Claiming A615 when the service provided is a follow-up assessment for the same diagnosis within a 12-month period; use A616 (Repeat Consultation) instead if criteria are met.
Billing Tips
- Ensure the written report sent to the referrer includes findings, opinions, and specific recommendations for management, as this is a core requirement for A615.
- A615 is not payable with E078 (Chronic Disease Assessment Premium); confirm that no other assessment codes (A613, A614, A611, A618) are billed concurrently for the same patient encounter.
Effective: June 1, 2025
Consultations and Visits
Haematology (61)
Consultations and Visits
Consultation
Written request from a referring physician, NP, or dental surgeon.
Written report (findings, opinions, recommendations) sent to the referrer.
Must include a general, specific or medical specific assessment, including a review of all relevant data (implying history and physical examination).
Start and stop times are not required for A615 (unlike comprehensive or time-based consultations).
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 (unless common medical records are maintained in hospital, LTC, or multi-specialty clinic).
The request identifies the consultant by name and/or specialty, 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.
For patients aged 17 years and older
For services not listed in the Haematology section, refer to the Internal Medicine section.
Physicians in hospital but not on duty in the ED should use A615 for patients seen in the Emergency or OPD.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.