1What Is the C446 OHIP Code?
C446 is an OHIP billing code used by oncologists for providing repeat consultations during a hospital in-patient stay. This is typically necessary when a patient's disease progresses, complications arise from treatment, or the treatment plan needs revisiting before discharge.
It's important to note that a repeat consultation requires a fresh written request from the referring physician, nurse practitioner, or dental surgeon for each repeat consultation billed under C446. A common oversight is failing to obtain a new request, which is essential for proper billing and reimbursement under this code.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A445 | Consultation | As required | Initial consultation provided in Medical Oncology in out-patient settings. |
| A446 | Repeat consultation | Repeat consultations require a new request | Equivalent to C446 but for out-patient settings. |
| A845 | Limited consultation | As needed | Limited consultations for specific issues in Medical Oncology. |
| C445 | Consultation | As required | Initial consultation provided in Medical Oncology during hospital in-patient stay. |
3Eligibility Requirements
C446 repeat consultations can be rendered in-person or virtually, but must be billed with code C446A when conducted through video. Telephone consultations are not eligible for billing under this code. In addition, a new written request from the referring professional is required for each repeat consultation under C446.
When providing care outside a hospital in-patient setting, use the equivalent out-patient code A446. Remember, failure to meet these requirements may result in reclassification to a general or specific assessment billing.
4What Your Clinical Note Must Show
For billing the C446 code, ensure that the following documentation is completed:
- A new written request from the referring physician, nurse practitioner, or dental surgeon.
- Clear notation of the clinical necessity for the repeat consultation.
- Details of the patient's current condition, including any progression or complications.
5Weak vs. Strong Note Examples
The strong note provides specific details about the patient's condition and a confirmed new request, justifying the need for a repeat consultation. The weak note lacks specifics and does not clearly demonstrate the requirement for a new consultation as stipulated by code C446.
Repeat consultation for same patient.
Discussed treatment plan again.
Reviewed the patient's ongoing symptoms and treatment regimen.
New request received from Dr. Smith due to patient's disease progression requiring reassessment of the treatment strategy.
Discussed alternative treatment options moving forward to address arising complications.
- Confirmed disease progression necessitating consultation.
- Details aligned with referring physician's new request.
