C346 – Repeat consultation
OHIP Surgical Procedures Code — RADIATION ONCOLOGY (34) · Schedule of Benefits
A repeat consultation is an additional assessment 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. A repeat consultation has the same requirements as a regular consultation, including the requirement for a new written request from a referring physician, nurse practitioner, or dental surgeon, as per . This service, with the 'C' prefix, is specifically for non-emergency in-patients in an acute care hospital, as defined in .
When to Use
- Use C346 when you are re-assessing an inpatient for the same condition after another physician has provided care in the interim, provided you have a new written referral.
- Use this code when the patient's condition has evolved or a new clinical question has arisen regarding the same diagnosis, necessitating a formal repeat consultation rather than a subsequent visit.
Common Pitfalls
- Billing C346 without a new, distinct written referral from the referring provider will lead to a rejection or a downgrade to a lower-value assessment fee.
- Attempting to use C346 for routine follow-up care or monitoring without the required intervening care by another physician will result in audit recovery.
- Confusing C346 with A346; remember that C346 is strictly for non-emergency inpatient hospital settings, whereas A346 is for office or outpatient settings.
Billing Tips
- Ensure the referring provider's written request is dated prior to the service date and clearly states the reason for the repeat consultation to satisfy the documentation requirements of GP19.
- If the patient is in an ICU or CCU, remember to append the C101 premium to the C346 claim to maximize the value of the inpatient assessment.
Effective: June 1, 2025
A. Consultations and Visits
RADIATION ONCOLOGY (34)
Consultation
Consultations, Hospital and Institutional Consultations and Assessments
A new written request from the referring physician, nurse practitioner or dental surgeon is required.
A copy of the written request for the consultation, signed by the referring provider, must be kept in the consulting physician's medical record (or on the common medical record if in a hospital).
The request must identify the consultant by name, the referring provider 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.
A repeat consultation is an exception to the general limit of one consultation per two consecutive 12-month periods for the same diagnosis.
In the preoperative preparation of a patient undergoing low risk elective surgical procedures (e.g., cataract surgery, colonoscopy, cystoscopy, carpal tunnel surgery, or arthroscopic surgery) under local anaesthesia and/or I.V. sedation, a preoperative consultation by any physician is only eligible for payment where the medical record demonstrates the consultation is medically necessary.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.