C745 – Not found
OHIP Surgical Procedures 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. A full consultation is an assessment rendered following a written request from a referring physician, <specialist>nurse practitioner</specialist>, or <specialist>dental surgeon</specialist> in connection with an insured dental procedure rendered in a hospital. The request is made because of the complexity, seriousness, or obscurity of the case, or because another opinion is requested by the patient or patient's representative. The service includes all work necessary to prepare a written report for the referring practitioner.
When to Use
- Use C745 for a hospital-based consultation when the clinical complexity is lower than a full consultation (C345) but still requires a formal written request from a referring practitioner.
- Select C745 when providing a second opinion on a patient already admitted to the hospital, provided the referral request is documented in the common medical record.
Common Pitfalls
- Billing C745 without a formal written request from the referring physician, nurse practitioner, or dental surgeon will lead to a rejection or a reduction to a standard assessment fee.
- Submitting C745 for a patient under 17 years of age is a common error; patients must be 17 or older to qualify for this specific code.
- Attempting to bill C745 on the same day as psychotherapy or psychiatric care for the same patient will trigger a rejection unless you document distinct, unrelated diagnoses for both services.
Billing Tips
- Ensure the referring practitioner's billing number is clearly recorded in your chart, as this is a mandatory requirement for audit compliance.
- If the consultation is performed in a hospital setting, verify that the referral request is captured in the shared hospital chart to satisfy the documentation requirements without needing a separate paper referral.
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 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.
Patient must be 17 years of age or older
See General Preamble to for rules regarding Non-Emergency Hospital In-Patient Services.
For emergency calls and other special visits to in-patients, use General Listings ('A' prefix codes) and Premiums when applicable - see General Preamble to .
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