W076 – Repeat Consultation
OHIP Neurology Code — Geriatrics (07) · 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. A repeat consultation has the same requirements as a consultation including the requirement for a new written request by the referring physician, nurse practitioner or dental surgeon. A written report of findings, opinions and recommendations must be sent to the referring practitioner.
When to Use
- Use W076 when you have previously provided a consultation (e.g., W071) for the same condition, but the patient was subsequently managed by the referring physician or another provider for a period before returning to you for a new assessment.
- Use W076 when a patient returns for a new evaluation of the same chronic issue after a significant interval where the referring physician assumed responsibility for care, provided a new written request is obtained.
Common Pitfalls
- Billing W076 without a new written request from the referring practitioner; unlike a follow-up visit (e.g., A075), a repeat consultation strictly requires a new referral.
- Confusing W076 with a standard follow-up visit; if there was no intervening care by another physician, the service does not meet the definition of a repeat consultation and should be billed as a repeat assessment or follow-up visit.
- Failing to document the specific 'intervening care' provided by the referring physician, which is a mandatory requirement to justify the 'repeat' status over a standard consultation.
Billing Tips
- Ensure the referring physician explicitly requests a new consultation in writing, as this is the primary audit trigger for distinguishing W076 from a routine follow-up.
- Always include the referring physician's billing number on the claim to satisfy the requirement that the service is linked to a specific, identifiable referring practitioner.
Effective: June 1, 2025
Consultations and Visits
Geriatrics (07)
Consultation
Hospital and Institutional Consultations and Assessments, Consultations
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 consultation includes the services necessary to enable the consultant to prepare a written report (including findings, opinions, and recommendations) to the referring physician, nurse practitioner or dental surgeon.
For emergency calls and other special visits to in-patients, use General Listings and Premiums when applicable - see General Preamble to .
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