1What Is the C726 OHIP Code?
A repeat consultation under C726 refers to a subsequent engagement between the consultant and a patient for the same issue after receiving interim care from another physician. In the context of occupational medicine, this often involves managing an in-patient's exposure to workplace hazards. Such a consultation is harnessed when the patient's conditions or the clinical picture evolve.
C726 is crucial for continued patient assessment when prior exposure risks change or new information arises, ensuring optimal patient care. Despite its clear necessity, challenges in securing a proper referral or misunderstanding the code's applicability can lead to billing errors.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A720 | Comprehensive occupational medicine consultation | Depends on patient needs | Used for an initial in-depth consultation regarding occupational medicine concerns. |
| A725 | Consultation | Depends on patient needs | General consultation service in occupational medicine. |
| A726 | Repeat consultation | Each requires a new referral | Repeat consultation for out-patient settings. |
| A925 | Limited consultation | Each requires a new referral | Used for limited scope occupational medicine consultations. |
3Eligibility Requirements
To bill C726 under OHIP, the following criteria must be met:
- Non-Emergency Setting: This service is rendered to in-patients in non-emergency hospital settings under the Occupational Medicine listing.
- Repeat Consultation: It's applicable when the same consultant sees the patient for a repeat assessment of the same issue, which another physician addressed in the interim.
- Written Request Required: A new written request from the referring physician, nurse practitioner, or dental surgeon must be provided and kept in the consultant's medical record. This does not apply in environments with shared records like hospitals or multi-specialty clinics.
- Exclusion from Frequency Limits: Repeat consultations are excluded from general frequency limits outlined in GP17.
4What Your Clinical Note Must Show
Ensure you have the following documentation to support billing under C726:
- A new, signed written request from the referring practitioner.
- Maintain this request in the patient's medical record, unless it's a shared record facility.
- Documentation of the consultation, noting any new findings or changes in the patient's condition.
5Weak vs. Strong Note Examples
The strong note succeeds by detailing the new referral and changes in the patient's condition, while the weak note lacks specificity and supporting documentation.
Patient seen for repeat consultation. Discussed previous exposure and concerns.
Patient presented for a repeat consultation due to evolving exposure history as noted by GP. New written request from Dr. Smith (referral attached).
Reviewed progress since last consultation and discussed recent workplace changes affecting exposure levels.
- Documented changes in patient’s exposure history.
- Attached the new written request from the referring practitioner.
