A675 – Limited Consultation
OHIP General Listings Code — Cardiology (60) · Schedule of Benefits
A consultation which is less demanding and, in terms of time, normally requires substantially less of the physician’s time than the full consultation. Otherwise, it has the same requirements as a full consultation, including a written request and report.
When to Use
- Bill A675 when a referring physician requests a focused cardiology opinion on a patient with established heart failure (428) where a brief review and specific question can be addressed without the extensive work of a full consultation (A605).
- Use A675 for a cardiology assessment of a patient with a new diagnosis of heart failure (428) requiring a written report, but where the clinical presentation suggests a less complex workup than a comprehensive consultation (A600).
- A675 is appropriate when a patient with known heart failure (428) requires a cardiology opinion on a specific management issue, and the physician can provide this with a limited review and report, distinct from a repeat consultation (A606).
Common Pitfalls
- Submitting A675 without a written request from a physician, NP, or dental surgeon, or failing to document this request in the chart (unless in a common record environment), will lead to claim rejection.
- Billing A675 for a patient with heart failure (428) within 12 months of a previous A675 or A605 consultation for the same diagnosis will result in the claim being denied due to usage limits.
- Failure to submit a written report to the referring provider after performing an A675 consultation is a common reason for audits and potential clawbacks.
Billing Tips
- Ensure the written request for A675 clearly specifies the patient's heart failure (428) and the particular cardiology question being asked to justify the limited nature of the consultation.
- If the patient is an inpatient, use C675 instead of A675, as A675 is strictly for outpatients.
Effective: June 1, 2025
Consultations and Visits
Cardiology (60)
Consultations and Visits
Consultation
Written request from referring provider identifying the consultant and patient
Written report 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.
If consultation requirements are not met, the fee is adjusted to a lesser assessment fee.
A675 is specifically for the Cardiology specialty.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.