C150 – Comprehensive endocrinology consultation
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A consultation rendered by a specialist in endocrinology who provides all the appropriate elements of a consultation and spends a minimum of seventy-five (75) minutes in direct contact with the patient, exclusive of time spent rendering any other separately billable intervention to the patient.
When to Use
- Use C150 for complex in-patient endocrine cases, such as a new diagnosis of diabetic ketoacidosis with significant comorbidities requiring a minimum of 75 minutes of face-to-face time.
- Use C150 when managing a patient with a rare endocrine tumor requiring extensive bedside counseling and physical assessment that exceeds the standard time threshold of C155.
Common Pitfalls
- Counting chart review, imaging analysis, or post-visit documentation time toward the 75-minute requirement, which will lead to a rejection or a mandatory downgrade to C155.
- Failing to record exact start and stop times in the medical record, which is a primary trigger for Ministry of Health audit recovery.
- Billing C150 when the patient is not a hospital in-patient, as this code is strictly restricted to in-patient settings unlike its out-patient counterpart A150.
Billing Tips
- Ensure your documentation explicitly states the start and stop times of direct patient contact to substantiate the 75-minute requirement during an audit.
- If the 75-minute threshold is not met, bill C155 instead to avoid a claim rejection or an automatic adjustment to a lower-paying code.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
In-patient
Consultation
Requires a written request from a referring physician, nurse practitioner, or dental surgeon (for hospital-based dental procedures).
Requires a written report (including findings, opinions, and recommendations) to be sent to the referring provider.
The physician must spend a minimum of 75 minutes in direct contact with the patient.
The start and stop times of the consultation must be recorded in the patient's permanent medical record.
The 75-minute minimum excludes time spent on other separately billable services and non-patient-facing time (e.g., chart review, documentation).
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.
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.
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