1What Is the C136 OHIP Code?
The C136 billing code is used for repeat consultations provided by internal medicine specialists for hospital in-patients. It's typically used when an internist is asked to reevaluate a patient they have previously seen during their admission, due to changes in the patient's condition such as electrolyte imbalances, decompensated heart failure, or the emergence of a new internal medicine issue.
A key aspect of billing C136 is that it requires a new written request from the referring physician, nurse practitioner, or dental surgeon for each repeat consultation. Without this request, the service cannot be billed under C136 and must be adjusted to a general or specific assessment.
It is crucial to differentiate between a repeat consultation and ongoing patient care. Ongoing daily care falls under subsequent hospital visit codes and not C136, which is specifically meant for distinct repeat assessments upon a new referral request.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A130 | Comprehensive internal medicine consultation | As per necessity, subject to individual consultation requirements. | Used for a comprehensive initial assessment by an internist in a non-emergency setting. |
| A135 | Consultation | As per necessity, subject to individual consultation requirements. | Standard initial consultation for patients requiring internist evaluation. |
| A136 | Repeat consultation | Each instance requires a new request. | Applies to repeat consultations in a non-hospital setting. |
| A435 | Limited consultation | As per necessity, subject to individual consultation requirements. | Used for limited scope consultations by an internist. |
3Eligibility Requirements
C136 may be billed in a hospital in-patient setting and can also be rendered virtually as C136A, but only through video as listed under eligible comprehensive virtual care services. This service is not eligible if provided by telephone. Each repeat consultation requires a new written request from the referring provider. Similar services rendered outside of the hospital campus should use code A136.
4What Your Clinical Note Must Show
Each C136 billing requires a new written request from a referring physician, nurse practitioner, or dental surgeon. Ensure documentation includes:
- Clear identification of the referring provider.
- Specific reason for the repeat consultation.
- Date of the request aligning with the date of service.
5Weak vs. Strong Note Examples
The strong note succeeds by explicitly referencing the written request and detailing the clinical context and actions taken during the repeat consultation, while the weak note lacks specific details and fails to mention the request.
Patient seen today. Repeat consultation billed. Follow-up on electrolytes.
Repeat consultation conducted as per Dr. Smith's written request received on 2023-10-05.
Patient presented with decompensated heart failure, requiring reassessment.
- Electrolyte levels reviewed and adjusted.
- Recommendations communicated to primary attending.
