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C925
C925 – 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. It is rendered to a hospital in-patient by a specialist in Occupational Medicine.
Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon
The consultant must provide a written report (including findings, opinions, and recommendations) to the referring provider.
The service must meet all the requirements of a consultation but is less demanding or time-consuming than a full consultation.
A copy of the signed written request must be kept in the medical record (or common hospital record).
Usage limits
Consultations rendered to the same patient by the same physician for the same diagnosis are limited to one service per two consecutive 12-month periods, with specific exceptions for hospital in-patients (e.g., a second consultation is eligible if rendered more than 12 months but less than 24 months after the first).
If the requirements for a consultation (e.g., written request, report) are not met, the amount payable will be adjusted to a lesser assessment fee.
Consultations requested by a Medical Trainee are adjusted to a lesser assessment fee.
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