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B602

B602B602

OHIP Paediatrics Code · Schedule of Benefits

When to Use

  • B602 is appropriate for a physician to bill when providing a consultation for a patient referred by another physician for a specific problem, and the consultation is not covered by another OHIP insured service.
  • Use B602 when a patient requires a specialist opinion on a condition that does not fit into a more specific consultation code (e.g., A001, A002, A003).
  • This code is suitable for situations where a physician is asked to review a complex case and provide recommendations, but no direct patient management is undertaken.

Common Pitfalls

  • Billing B602 for routine follow-up visits or for services that could be billed under a more specific diagnostic or procedural code.
  • Submitting B602 when the patient is already an active patient of the physician for the condition being discussed, as this may indicate a lack of true referral for a new problem.
  • Failure to clearly document the referral source and the specific reason for the consultation, which can lead to claim rejection or audit issues.

Billing Tips

  • Ensure the patient's chart clearly indicates a referral from another physician for the specific issue addressed during the B602 consultation.
  • Verify that no other OHIP insured service, such as a diagnostic code or a more specific consultation code, is applicable before billing B602.
Provider Fee$0.00
Specialist Fee$0.00

Effective: December 1, 2015

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