C586 – Repeat Consultation
OHIP Surgical Procedures Code — Laboratory Medicine (28) · 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. 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. This service is for a non-emergency hospital in-patient.
When to Use
- Use C586 when you are re-evaluating a non-emergency hospital inpatient for the same condition after another physician has provided care in the interim.
- Use this code when the referring physician provides a new, distinct written request for a follow-up consultation on a previously assessed inpatient issue.
Common Pitfalls
- Billing C586 without a new, formal written referral request on file, which is a mandatory requirement for every repeat consultation.
- Claiming C586 for a routine follow-up visit where no intervening care by another physician has occurred, which should instead be billed as a subsequent visit.
- Attempting to claim C586 in conjunction with special visit premiums, which are strictly prohibited for this code.
Billing Tips
- Ensure the referring physician's new request is documented in the common hospital chart to satisfy the audit requirement for a 'written request'.
Effective: June 1, 2025
Consultations and Visits
Laboratory Medicine (28)
Consultation
Consultations, Hospital and Institutional Consultations and Assessments
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 written request identifies the consultant by name, 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.
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.
Applicable to specialists in Haematopathology, Neuropathology, Medical Biochemistry, Medical Microbiology, Anatomic and General Pathology.
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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