A646 – Specific Re-Assessment - General Thoracic Surgery
OHIP General Listings Code — General Thoracic Surgery (64) · Schedule of Benefits
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 physician in the interval following the initial consultation but preceding the repeat consultation.
When to Use
- Bill A646 when you previously saw a patient for a specific thoracic issue, another physician provided care for that same issue, and you are now seeing the patient again for follow-up on that original problem.
- Use A646 if the patient's primary care physician or another specialist referred them back to you for the same thoracic condition after an intervening physician managed it, and you are providing a repeat consultation.
- This code is appropriate when a patient was discharged from your care for a thoracic condition, another physician managed them, and they are now returning to you for a repeat consultation on that same condition, requiring a new referral.
Common Pitfalls
- Billing A646 when no other physician has seen the patient for the same presenting problem since your initial consultation; this should be billed as A645.
- Failure to obtain a new written request from the referring physician, nurse practitioner, or dental surgeon for the repeat consultation can lead to rejection.
- Not submitting a written report of your findings and recommendations to the referring practitioner after the A646 service will result in claim rejection.
Billing Tips
- Ensure the intervening care by another physician is clearly documented in the patient's chart to support the use of A646 over A645.
- A646 is billed instead of A645 only when the specific criteria of intervening care by another physician are met; otherwise, use A645.
Effective: June 1, 2025
Consultations and Visits
General Thoracic Surgery (64)
Consultations and Visits
Consultation
Must be rendered by the same consultant who performed the initial consultation.
Must be for the same presenting problem as the initial consultation.
Care must have been rendered to the patient by another physician in the interval following the initial consultation but preceding the repeat consultation.
Requires a new written request by the referring physician, nurse practitioner, or dental surgeon.
Requires a written report of findings and recommendations to the referring practitioner.
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