C675 – Limited Consultation
OHIP Surgical Procedures Code — Cardiology (60) · 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 a full consultation (A605/C605). A consultation is an assessment rendered following a written request from a referring physician, nurse practitioner, or dental surgeon who, in light of his/her professional knowledge of the patient, requests the opinion of a specialist 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 with findings, opinions, and recommendations. For full consultation requirements, see .
When to Use
- Use C675 for a focused cardiac assessment where the clinical question is narrow and the time required is significantly less than a full consultation (C605).
- Select this code for a second opinion on a stable cardiac condition where the referring provider requires specific guidance rather than a comprehensive management plan.
- Utilize C675 when the complexity of the patient's cardiac history does not warrant the extensive documentation and time investment required for a full C605 consultation.
Common Pitfalls
- Billing C675 without a formal, written referral request on file, which will lead to a rejection or a reduction to a lower-paying assessment code upon audit.
- Submitting C675 for patients under 17 years of age, as this code is restricted to adults; C765 must be used for pediatric patients.
- Failing to provide a detailed written report to the referring provider, as the consultation fee is contingent upon the delivery of findings and recommendations.
Billing Tips
- Ensure the referral request explicitly states the reason for the consultation and the specific service required to satisfy the documentation requirements of GP16.
- If the consultation is performed in a hospital setting, ensure the referral is clearly documented in the shared medical record to avoid payment adjustments.
Effective: June 1, 2025
Consultations and Visits
Cardiology (60)
Consultation
Hospital and Institutional Consultations and Assessments, Consultations
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.
A consultation includes the services necessary to enable the consultant to prepare a written report (including findings, opinions, and recommendations) to the referring physician, nurse practitioner or dental surgeon.
Applicable to patients 17 years of age and older. For patients 16 years of age and under, see C765.
In the preoperative preparation of a patient undergoing low risk elective surgical procedures (cataract surgery, colonoscopy, cystoscopy, carpal tunnel surgery, or arthroscopic surgery) under local anaesthesia and/or I.V. sedation, a preoperative consultation by any physician is only eligible for payment where the medical record demonstrates the consultation is medically necessary. Such medically necessary consultations are considered very uncommon.
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