C246 – Repeat consultation
OHIP Surgical Procedures Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A repeat consultation is an additional consultation rendered by the same consultant for the same presenting problem, following care provided by another physician in the interval after the initial consultation. This service has the same requirements as a standard consultation, including the need for a new written request from a referring physician, nurse practitioner, or dental surgeon. As a 'C' prefix code, this service is specifically for non-emergency acute care hospital in-patients. The service includes all constituent elements of an assessment and requires a written report be sent to the referring practitioner. Refer to for the definition of a repeat consultation and for the full requirements of a consultation.
When to Use
- Use C246 when you have already provided an initial consultation (C245) for the same problem, and the patient requires a new assessment after another physician has provided care in the interim.
- Use C246 for a follow-up consultation in an acute care hospital setting when a new, formal written request is generated by the attending physician or another practitioner to address the original presenting problem.
Common Pitfalls
- Billing C246 without a new, distinct written request from the referring practitioner will lead to a clawback, as it is often mistaken for a subsequent hospital visit (C002).
- Submitting C246 for a patient you are currently managing as the Most Responsible Physician (MRP) is incorrect; this code is strictly for a consultant role where a referral is required.
- Failing to document a new written report sent back to the referring practitioner for the repeat consultation will result in the service being downgraded to a standard hospital visit during an audit.
Billing Tips
- Ensure the referring practitioner's name and billing number are clearly documented in the patient's chart for every instance of C246 to satisfy the mandatory referral requirement.
- If you are providing ongoing care for the same problem without a new referral request, bill a subsequent hospital visit (C002) instead of C246 to avoid rejection.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Consultation
Consultations, Hospital and Institutional Consultations and Assessments
A repeat consultation has the same requirements as a consultation including the requirement for a new written request by the referring physician, nurse practitioner or dental surgeon.
A copy of the written request for the consultation, signed by the referring practitioner, must be kept in the consulting physician's medical record. In a hospital where common medical records are maintained, the written request may be contained on the common medical record.
The request must identify the consultant by name, the referring practitioner by name and billing number, and the patient by name and health number.
The written request must set out the information relevant to the referral and specify the service(s) required.
The consultant must prepare a written report (including findings, opinions, and recommendations) to the referring practitioner.
NON-EMERGENCY HOSPITAL IN-PATIENT SERVICES. See General Preamble to . For emergency calls and other special visits to in-patients, use General Listings and Premiums when applicable - see General Preamble to .
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