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H055
H055 – Consultation
OHIP Consultations and Visits Code — CONSULTATIONS AND VISITS · Schedule of Benefits
An Emergency Room (ER) Physician Consultation rendered by a specialist in emergency medicine (FRCP).
Per the General Preamble on page , a consultation by an ER Physician is claimed using H055 for a specialist in emergency medicine (FRCP) or H065 for all other physicians.
As defined on page , a consultation is an assessment rendered following a written request from a referring physician, nurse practitioner, or dental surgeon 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 their representative. A consultation includes all services necessary for the consultant to prepare a written report to the referring practitioner, including findings, opinions, and recommendations.
Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon
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. In a hospital, long-term care institution or multi-specialty clinic with common medical records, the written request may be on the common record.
The request must identify the consultant by name, the referring practitioner by name and billing number, and the patient by name and health number.
The written request must set out relevant information and specify the service(s) required.
ER reports constitute adequate documentation of the written report of the consultation as long as the rendering of all constituent elements is clearly documented on all copies of the report.
See for definitions and conditions for physicians on duty.
All other consultations and visits - use the listings for Family Practice & Practice In General.
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