1What Is the C006 OHIP Code?
A repeat consultation (C006) allows family physicians to provide additional expert opinion on the same presenting problem after interim patient care by another physician. This typically occurs in a hospital setting when a family physician is requested to reassess a problem during a patient's in-patient stay. Repeat consultations are crucial in ensuring continuity and quality of care but require a new referral each time.
The necessity for such consultations often arises when patient conditions evolve or when further specialized input is needed after initial management by a different provider. Due to the need for meticulous adherence to referral processes, C006 can sometimes be overlooked if a new written request is not clearly documented, leading to billing adjustments.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A914 | GP focused practice comprehensive consultation by Video | Once per 12 months | This service involves a comprehensive consultation conducted via video. |
| A006 | Repeat consultation | Unlimited, with new referral | Similar to C006, used outside hospital in-patient settings. |
| A010 | GP focused practice consultation by Video | Once per 12 months | A standard consultation rendered by video. |
| A011 | GP focused practice repeat consultation by Video | Unlimited, with new referral | A repeat consultation conducted via video. |
3Eligibility Requirements
To be eligible for billing under code C006, repeat consultation services must meet several conditions:
- A new written request for the consultation must be provided by a referring physician, nurse practitioner, or dental surgeon each time services are rendered.
- This written request needs to be maintained in the consulting physician's medical records, except when common medical records are kept in a hospital, long-term care institution, or multi-specialty clinic.
If these requirements are not met, the amount paid will decrease to a general or specific assessment fee. Unlike other consultation codes, repeat consultations under C006 do not count towards consultation frequency limits outlined in GP17.
4What Your Clinical Note Must Show
Maintain accurate records for each repeat consultation:
- New written request from the referring physician, nurse practitioner, or dental surgeon.
- Record of the request stored in the physician's medical records (or common medical records in approved institutions).
- Evidence of prior care by another physician for the same problem before this repeat consultation.
5Weak vs. Strong Note Examples
The strong note provides clear documentation of the referral, prior care, and the clinical assessment, supporting the necessity of the repeat consultation. The weak note lacks corroborative details and necessary documentation.
Patient seen for repeat consultation; discussed management options.
Repeat consultation performed based on a request from Dr. Smith (attached) regarding unresolved chest pain.
Review of patient's records from interim care by Dr. Jones, confirming necessity for reassessment.
Management plan revised with consideration of new symptoms.
- Attached referral request.
- Details of prior interim care.
- Updated management plan documented.
