C726 – Repeat consultation, Occupational Medicine, hospital in-patient
OHIP Surgical Procedures Code · 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.
When to Use
- Use C726 when you are re-evaluating a patient for the same occupational medicine issue after another physician (e.g., the MRP or a specialist) has provided active care in the interim.
- Use this code for a follow-up assessment when the clinical situation has evolved sufficiently to warrant a formal repeat consultation report, rather than a standard subsequent visit (C723).
Common Pitfalls
- Billing C726 without a new, distinct written referral request for the repeat consultation will lead to audit recovery, as the initial referral does not cover subsequent repeat consultations.
- Failing to document that another physician provided care in the interval between your initial consultation and this repeat visit will result in the claim being downgraded to a lower-value assessment code.
Billing Tips
- Ensure your documentation explicitly names the physician who provided care in the interval to satisfy the 'interval care' requirement, which is the primary differentiator between C726 and a standard subsequent visit (C723).
Effective: April 1, 2026
Consultation
Consultation
A written request from a referring physician, nurse practitioner, or dental surgeon is mandatory.
The consultant must prepare a written report (findings, opinions, recommendations) and send it to the referring provider.
A new written request is required for every repeat consultation.
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.
The consultant is required to perform a general, specific or medical specific assessment, including a review of all relevant data.
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