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W106
W106 – Repeat consultation
OHIP Consultations and Visits Code — CONSULTATIONS AND VISITS · Schedule of Benefits
Levels of this visit
The W10x codes in this part of the Schedule of Benefits, lowest fee first. Bill the level the history and examination support.
- $45.90
W106 Repeat consultation(this code)
Repeat consultation rendered to a non-emergency long-term care in-patient.
- $95.60
W105 Consultation
A consultation is an assessment rendered in a long-term care institution following a written request from a referring practitioner, which can be a physician, nurse practitioner…
Repeat consultation rendered to a non-emergency long-term care in-patient. Non-Emergency Long-Term Care In-Patient Services include chronic care hospitals, convalescent hospitals, nursing homes, homes for the aged and designated chronic or convalescent care beds in hospitals and nursing homes or homes for the aged, other than patients in designated palliative care beds. For emergency calls and other special visits to in-patients, use General Listings and Premiums when applicable (see General Preamble to ).
Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon
All insured services must be documented in appropriate records. The Act requires that the record establish that:
1. an insured service was provided;
2. the service for which the account is submitted is the service that was rendered; and
3. the service was medically necessary.
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.
Usage limits
OR([1, "12_months", "per_patient_per_physician", "Limited to one per patient per physician per 12 month period"], [2, "12_months", "per_patient_per_physician", "The limit is increased to two per 12 month period if the patient presents a second time with a complaint for which a clearly different and unrelated diagnosis is made."])
The 'W' prefix codes are for non-emergency in-patient services rendered in a long-term care institution.
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