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W325 – Limited consultation

OHIP Consultations and Visits Code — CONSULTATIONS AND VISITS · Schedule of Benefits

A limited consultation is a consultation service rendered by a Genetics specialist which is less demanding and normally requires substantially less of the physician's time than a full consultation. Otherwise, a limited consultation has the same requirements as a full consultation, including a written request from a referring practitioner and a written report of findings and recommendations sent back to the referring practitioner. This service is provided to non-emergency patients in long-term care institutions, which include Chronic Care Hospitals, Convalescent Hospitals, Nursing Homes, Homes for the Aged, and designated chronic or convalescent care beds in hospitals, excluding patients in designated palliative care beds. Refer to the General Preamble (, , ) for full consultation requirements.
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.
The request must identify the consultant by name, the referring physician/nurse practitioner/dental surgeon by name and billing number, and the patient by name and health number.
The written request must set out information relevant to the referral and specify the service(s) required.
The consultant must prepare a written report including findings, opinions, and recommendations to the referring practitioner.
Usage limits
OR([1, "24_months", "per_patient_per_physician", "For the same diagnosis, limited to one service per two consecutive 12 month periods."], [1, "12_months", "per_patient_per_physician", "For a clearly defined unrelated diagnosis."])

A consultation is payable at nil if a genetic assessment (K016) or genetic care (K222) has previously been claimed by the same physician.

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