All codes
C655
C655 – Limited consultation
OHIP Consultations and Visits Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A limited consultation is a consultation which is less demanding and, in terms of time, normally requires substantially less of the physician's time than the full consultation. Otherwise, a limited consultation has the same requirements as a full consultation (). This service is for a non-emergency hospital in-patient, as indicated by the 'C' prefix ().
As a consultation, this service requires a written request from a referring physician, nurse practitioner, or dental surgeon who requests the opinion of a consultant physician because of the complexity, seriousness, or obscurity of the case, or because another opinion is requested by the patient. The consultant must prepare a written report of their findings, opinions, and recommendations to the referring practitioner. The request and report must be documented in the medical record ().
Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon
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. For services in a hospital where common medical records are maintained, the written request may be on the common record. ()
The request must identify the consultant by name, the referring practitioner 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 consultation includes the services necessary to enable the consultant to prepare a written report (including findings, opinions, and recommendations) to the referring practitioner. ()
Usage limits
OR([1, "24_months", "per_patient_per_physician", "For the same diagnosis. A second consultation for the same diagnosis is payable between 12 and 24 months if the patient is a hospital inpatient or in an Emergency Department."], [1, "12_months", "per_patient_per_physician", "For a clearly defined unrelated diagnosis."])
For Services not listed, refer to Internal Medicine Section.
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