C606 – Repeat consultation - Cardiology
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. 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 provided by a specialist in Cardiology (60) and is rendered in a non-emergency hospital in-patient setting.
When to Use
- Use C606 when you have already provided an initial consultation (C605) for a specific cardiac condition, and the patient has since been managed by another physician (e.g., the primary care provider or hospitalist) before requiring your re-evaluation.
- Use C606 when a new, distinct written request for a consultation is received from a referring practitioner for the same presenting problem after an interval of care by another provider.
Common Pitfalls
- Billing C606 without a new, formal written request from the referring practitioner will lead to a rejection or a downgrade to a subsequent visit fee.
- Claiming C606 for follow-up visits where you have been the sole provider managing the patient's care since the initial consultation; this should be billed as a subsequent visit (C603 or C604) instead.
- Failing to document the specific interval of care provided by another physician, which is a mandatory requirement to distinguish C606 from a standard subsequent visit.
Billing Tips
- Ensure the referring practitioner's written request is clearly dated and filed in the hospital record to satisfy audit requirements for the 'repeat' status.
- Always verify that the patient has been under the care of another physician in the interim; if you have been providing continuous care, C606 is not applicable.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Consultation
Consultations, Hospital and Institutional Consultations and Assessments
A copy of the written request for the consultation, signed by the referring practitioner, must be kept in the patient's medical record. In a hospital, the written request may be contained on the common medical record.
A written report including findings, opinions, and recommendations must be provided to the referring practitioner.
The 'C' prefix indicates this service is for non-emergency hospital in-patients.
Claims for Cardiology services under this section should be submitted with diagnostic code 428.
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