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A745
A745 – Limited consultation
OHIP Consultations and Visits Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A limited consultation is 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, a limited consultation has the same requirements as a full consultation.
Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon
A written request from the referring provider must be signed and kept in the consultant's medical record.
The request must identify the consultant, the referring provider (name and billing number), and the patient (name and health number).
The request must specify the information relevant to the referral and the services required.
The consultant must prepare a written report (findings, opinions, and recommendations) to the referring provider.
The consultant must perform a general, specific, or medical specific assessment, including a review of all relevant data.
Usage limits
Consultations for the same patient by the same physician for the same diagnosis are limited to one service per two consecutive 12-month periods (with specific exceptions for repeat consultations or hospital/ED scenarios). Consultations for a clearly defined unrelated diagnosis are limited to one service every 12 months.
A745 is eligible for Special Visit Premiums (Travel and First Person Seen) when rendered in qualifying locations (ED, OPD, In-patient, LTC, Home, or Office) under non-elective circumstances or sacrifice of office hours.
The time at which the special visit takes place must be documented on the medical record to claim special visit premiums.
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