1What Is the C156 OHIP Code?
C156 is a billing code under Ontario's OHIP system designated for repeat consultations in endocrinology for non-emergency hospital in-patients. A typical scenario involves re-evaluating patients who have been previously consulted but exhibit recurring issues such as significant hypoglycemia or hyperglycemia. The repeat consultation ensures specialized endocrinological expertise is applied to manage ongoing complexities of the patient's condition.
Physicians may commonly overlook billing C156 due to its specific requirement for a new written request from a referring health professional, even for known patients. Additionally, some may erroneously apply general assessment codes where a repeat consultation is appropriate, missing potential revenue.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A150 | Comprehensive endocrinology consultation | Not specified | Used for initial comprehensive consultations in endocrinology. |
| A155 | Consultation | Not specified | For standard consultations following a referral. |
| A156 | Repeat consultation | Excludes consultation frequency limits | Applies to out-patient settings equivalent to C156. |
| A255 | Limited consultation | Not specified | Used for consultations requiring limited time and resources. |
3Eligibility Requirements
To bill C156, the service must be a repeat consultation specifically associated with the endocrinology and metabolism specialty, rendered to a non-emergency hospital in-patient. It must follow an initial consultation and occur after another physician has been involved in the patient's care. Each repeat consultation requires a new written request from the referring physician, nurse practitioner, or dental surgeon, filed in the consulting physician's medical record. For services rendered virtually, C156 must be delivered via video, as telephone consultations do not qualify.
4What Your Clinical Note Must Show
Ensure the following documentation is included:
- A copy of the new written request from the referring provider.
- Details of the presenting problem and treatment provided.
- Evidence of the consultation occurring after another physician's care.
5Weak vs. Strong Note Examples
The strong note succeeds by clearly outlining the justification for the repeat consultation and documenting the steps taken, whereas the weak note fails to provide context or evidence of a new referral.
Consulted with Mr. Doe for diabetes management.
Discussed medication adjustments.
Consulted with Mr. John Doe, referred by Dr. Smith, due to recurring severe hypoglycemia after initial treatment.
A comprehensive review of Mr. Doe's glucose management plan was conducted, adjusting insulin dosages and dietary recommendations based on current symptoms and lab results.
- Clearly documents the specific reason for the repeat consultation.
- Includes a new written request from the referring physician.
- Details the actions taken and any changes to patient management.
