1What Is the A006 OHIP Code?
What is an A006 Repeat Consultation?
The A006 billing code is used for repeat consultations in family medicine in Ontario. This code applies when a family physician is asked to reassess a patient for the same issue following the involvement of another healthcare provider in the interim. A repeat consultation requires a new written request from the referring professional and is critical when the initial treatment plan has not resolved the presenting problem.
Family physicians frequently use this code in outpatient clinic settings when a patient returns after consultative interventions from other providers did not achieve desired outcomes. It is essential to meet the documentation criteria to avoid downgrades to a simpler assessment fee.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A914 | GP focused practice comprehensive consultation by Video | As per necessity | Video-based comprehensive consultations for focused practices. |
| A010 | GP focused practice consultation by Video | As per necessity | Standard video consultations in general practice. |
| A011 | GP focused practice repeat consultation by Video | As per necessity | Video repeat consultations for family practice. |
| A320 | Special Medical Assistance in Dying (MAID) consultation | As per necessity | Consultations related to Medical Assistance in Dying. |
3Eligibility Requirements
Eligibility Requirements for A006
To bill the A006 code, the following criteria must be met:
- New Written Request: A new written request for the consultation is mandatory. This must be authored by the referring physician, nurse practitioner, or dental surgeon.
- Problem Definition: The repeat consultation is focused on the same presenting problem previously assessed. The consultant must have conducted an initial evaluation of the patient beforehand.
- Documentation Maintenance: Retain a copy of the written request for the consultation in the consulting physician's medical record, except in cases within hospitals, long-term care, or multi-specialty clinics where joint records are kept.
- Exclusion from Frequency Limits: Repeat consultations are excluded from consultation frequency limits outlined in GP17, allowing for flexible usage to reassess the patient for the same diagnosis.
Failure to meet these requirements results in the consultation fee being adjusted to a general or specific assessment.
4What Your Clinical Note Must Show
Ensure accurate record-keeping to meet OHIP billing requirements.
- Maintain a copy of the written consultation request in the patient's file.
- Ensure the request is signed by the referring professional.
- In multi-specialty settings, confirm access to shared medical records.
5Weak vs. Strong Note Examples
The strong note succeeds by providing detailed context, referencing both initial and subsequent patient interactions, while specifying changes to the care plan. The weak note lacks depth and specific information.
Patient seen for repeat consultation. Discussed issues and adjusted care plan. No further details provided.
Patient was seen for repeat consultation regarding chronic pain since the initial assessment by Dr. Smith on 2023-01-10.
A detailed review of symptoms was conducted, including recent developments. Adjustments to the treatment plan were made.
- Reviewed all previous consultations and notes.
- Reassessed patient's current condition and modifications to care plan documented.
