C136 – Repeat consultation
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · 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
- Use C136 when a patient is re-referred by a physician for the same condition after the patient was discharged or managed by another provider during the interim.
- Use C136 when a specialist is asked to re-evaluate a patient for a previously consulted issue after the primary team or another specialist has provided active management in the interval.
Common Pitfalls
- Billing C136 without a new, distinct written referral request for the repeat assessment, which is a mandatory requirement for this code.
- Attempting to bill C136 when no other physician has provided care to the patient in the interval between the initial consultation and the repeat request.
- Billing C136 on the same day as a C132 subsequent visit, which will result in an automatic rejection.
Billing Tips
- Ensure the referring physician explicitly documents the interval care provided by another physician to satisfy the audit requirement for C136.
- If the criteria for a repeat consultation are not met, bill a C134 (Re-assessment) instead, as C136 is strictly reserved for cases involving intervening care by another provider.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
In-patient
Consultation
New written request from a referring physician, nurse practitioner, or dental surgeon
Care must have been rendered by another physician in the interval between the initial and repeat consultation
Written report must be sent to the referring provider
Consultant must perform a general, specific, or medical specific assessment
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 the requirements for a repeat consultation are not met (e.g., no new referral or no interval care), the service should be billed as a re-assessment (e.g., C134).
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