C580 – Comprehensive laboratory medicine consultation
OHIP Surgical Procedures Code · Schedule of Benefits
A consultation rendered by a specialist in laboratory medicine who provides all the appropriate elements of a consultation and spends a minimum of 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 C580 when a complex laboratory medicine consultation requires at least 75 minutes of direct patient interaction, such as managing a patient with severe transfusion reactions or complex hematological disorders requiring bedside assessment.
- Use this code for inpatient consultations where the complexity of the diagnostic interpretation necessitates a prolonged face-to-face discussion with the patient to gather clinical history that is not apparent from the laboratory data alone.
Common Pitfalls
- Including non-patient-facing time, such as reviewing pathology slides, electronic health records, or writing the consultation report, toward the 75-minute threshold will trigger a rejection or audit recovery.
- Failing to explicitly document the start and stop times of the direct patient contact in the medical record will result in the claim being downgraded to a lower-paying code like C285.
- Billing C580 when another consultation code (e.g., C285 or C585) has already been submitted for the same hospital admission, as only one consultation is permitted per admission.
Billing Tips
- Ensure your documentation clearly delineates the 75 minutes of direct patient contact from any other separately billable procedures or administrative tasks performed during the encounter.
- If the 75-minute threshold is not met due to unforeseen circumstances, bill the appropriate standard laboratory medicine consultation code (C285) instead to avoid a rejection for insufficient time.
Effective: April 1, 2026
Hospital In-patient
Consultation
Must satisfy all the elements of a consultation as defined in the General Preamble ().
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.
Minimum of 75 minutes in direct contact with the patient, exclusive of time spent rendering any other separately billable intervention to the patient.
The start and stop times must be recorded in the patient’s permanent medical record.
A written report (including findings, opinions, and recommendations) must be provided to the referring physician, nurse practitioner or dental surgeon.
Subject to the same conditions as A580.
Unless otherwise specified in the Schedule, the calculation of time for comprehensive laboratory medicine consultations excludes (1) time devoted to any other service or procedure for which an amount is payable in addition to the consultation and (2) non-patient-facing time such as such as time spent reviewing charts, imaging, or documentation, etc.
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