C735 – Diagnostic consultation - nuclear medicine
OHIP Surgical Procedures Code — NUCLEAR MEDICINE (63) · Schedule of Benefits
A diagnostic consultation rendered to a non-emergency hospital in-patient by a specialist in Nuclear Medicine. Per the Schedule, this service is subject to the same conditions as a diagnostic consultation under the general listings, A735. A consultation is an assessment rendered following a written request from a referring physician, nurse practitioner, or dental surgeon for the opinion of a specialist.
When to Use
- Use C735 when providing a formal consultation for a non-emergency hospital inpatient at the request of an attending physician to interpret nuclear medicine findings or determine the necessity of a nuclear medicine procedure.
- Use this code when the patient is already admitted to the hospital, distinguishing it from the A735 code which is reserved for outpatient or office-based consultations.
Common Pitfalls
- Billing C735 when a special visit premium is applicable; if you are called in to the hospital for an urgent assessment, you must use the appropriate 'A' prefix code instead of the 'C' prefix.
- Failing to document the formal written request from the referring physician, which is a mandatory requirement for all consultation codes regardless of the hospital setting.
- Submitting C735 for a routine interpretation of a scan without a formal request for a specialist opinion, which risks a downgrade to a lesser assessment fee upon audit.
Billing Tips
- Ensure the referring physician's name and billing number are clearly recorded in the patient's chart to satisfy the documentation requirements for a valid consultation.
- Always verify that the patient is an inpatient at the time of service, as C735 is strictly restricted to non-emergency hospital inpatient settings.
Effective: June 1, 2025
A. Consultations and Visits
NUCLEAR MEDICINE (63)
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 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.
subject to the same conditions as A735
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.