C446 – 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. This service has the same requirements as a consultation, including the need for a new written request from the referring practitioner. As per , a consultation is an assessment rendered following a written request from a referring physician, nurse practitioner, or dental surgeon. It requires the consultant to prepare a written report with findings, opinions, and recommendations for the referring practitioner. The request must be documented in the patient's medical record.
When to Use
- Use C446 when a patient has been seen by you previously for the same condition, but has since been managed by another physician (e.g., a primary care provider or another specialist) before returning to your care.
- Use C446 when a patient returns for a new assessment of a previously consulted problem after a period of active management by a different physician, provided a new written referral is obtained.
Common Pitfalls
- Billing C446 without a new written request from the referring practitioner; unlike follow-up visits, a repeat consultation strictly requires a new referral.
- Billing C446 for a patient you are currently managing without an intervening period of care by another physician, which should instead be billed as a follow-up assessment (e.g., A445/C445).
- Failing to document the specific 'intervening care' provided by another physician, which is a mandatory requirement to justify the 'repeat' status over a standard follow-up.
Billing Tips
- Ensure the new written referral explicitly references the current clinical context to satisfy the requirement that the request sets out information relevant to the specific repeat service required.
- Always verify that the referring physician's billing number is included in your documentation, as this is a core requirement for audit compliance for all consultation codes.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Consultation
Hospital and Institutional Consultations and Assessments, Consultations
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 physician, nurse practitioner or dental surgeon 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 identifies the consultant by name, the referring practitioner by name and billing number, and the patient by name and health number.
The written request sets out the information relevant to the referral and specifies the service(s) required.
Services are for non-emergency hospital in-patients. See to .
For emergency calls and other special visits to in-patients, use General Listings and Premiums when applicable - see to .
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