W346 – Repeat consultation
OHIP Neurology Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A repeat consultation is an additional consultation rendered by the same consultant for the same presenting problem, following care rendered to the patient by another physician in the interval following the initial consultation. This service has the same requirements as a consultation, including the need for a new written request from the referring physician, nurse practitioner, or dental surgeon, as detailed in the General Preamble (). This specific code applies when the service is rendered by a specialist in Otolaryngology (24) in a non-emergency long-term care inpatient setting.
When to Use
- Use W346 when you have already provided an initial consultation (A345) for the same Otolaryngology issue and a new written referral is received after the patient has been managed by another physician in the interim.
- Apply this code specifically for repeat consultations occurring in a non-emergency long-term care inpatient setting, distinguishing it from standard office-based repeat consultations.
Common Pitfalls
- Billing W346 without a new, distinct written request from the referring physician will trigger a rejection or an automatic adjustment to a lower-valued assessment code.
- Confusing W346 with W345; ensure the setting is strictly a long-term care inpatient facility to avoid audit discrepancies regarding location-based billing rules.
- Failing to document the 'interval of care' by another physician, which is a mandatory requirement for the definition of a repeat consultation under the General Preamble.
Billing Tips
- Always verify that the referring physician's name and billing number are explicitly recorded in your chart, as this is a strict requirement for W346 eligibility.
- If the patient is under 16 years of age, ensure the appropriate age premium is applied to the W346 base fee to maximize the claim value.
Effective: June 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Consultation
Consultations, Hospital and Institutional Consultations and Assessments
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 setting with a common medical record, the written request may be on that record.
The request must identify the consultant by name, the referring physician, nurse practitioner or dental surgeon by name and billing number, and identify the patient by name and health number.
The written request must set out the information relevant to the referral and specify the service(s) required.
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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