1What Is the W106 OHIP Code?
The OHIP W106 billing code is used for repeat consultations within Family Medicine. This consultation is an additional visit by the same consulting physician for the same patient due to the same presenting problem. It's typically used after an initial consultation, and subsequent patient evaluation by another physician, necessitates further consultation by the original consultant.
In the context of Family Medicine, this code is often used for patients residing in nursing homes, homes for the aged, or chronic care facilities. Such settings require the consultant to revisit the problem on-site without moving the patient out of the facility. This can be critical in managing ongoing or unresolved medical issues where a patient's condition has been previously assessed.
Despite its usefulness, this code is often overlooked when there is a failure to acquire a new written request for the repeat consultation. Ensure proper documentation to avoid missed billing opportunities.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A914 | GP focused practice comprehensive consultation by Video | unrestricted | Comprehensive video consultation for GP practices. |
| A006 | Repeat consultation | unrestricted | In-person repeat consultation in Family Practice. |
| A010 | GP focused practice consultation by Video | unrestricted | Initial consultation via video for Family Practice. |
| A011 | GP focused practice repeat consultation by Video | unrestricted | Repeat consultation through video conferencing in GP focused practices. |
3Eligibility Requirements
To bill OHIP code W106 for a repeat consultation, the following eligibility requirements must be met:
- A new written request for the consultation must be obtained, signed by the referring physician, nurse practitioner, or dental surgeon. This request must be kept in the consulting physician's medical record, unless the consultation occurs in a hospital, long-term care institution, or multi-specialty clinic where common medical records are used.
- The repeat consultation must relate to the same presenting problem after initial care and an interim consultation by another physician.
- Repeat consultations are not subject to the consultation frequency limits applied by OHIP. However, if these specific requirements are not met, the billing may be downgraded to a general or specific assessment fee, rather than the repeat consultation fee.
4What Your Clinical Note Must Show
Ensure these items are collected for compliance.
- Copy of the new written request for the consultation, signed by referring physician, nurse practitioner, or dental surgeon.
- Maintain this document in the patient's medical record unless shared records are used.
- Evidence of previous consultation by another physician for the same issue.
- Clinical notes detailing the necessity of repeat consultation.
5Weak vs. Strong Note Examples
The strong note is successful because it specifies the patient's setting, initial consultation details, intervening care, and the content of the repeat consultation. The weak note lacks specific details and supporting documentation.
Patient seen for follow-up. Previously consulted another doctor. Repeat consultation performed.
Resident of ABC Nursing Home, John Doe, initially consulted on July 10th for chronic ulcer management.
Referred back by Dr. Smith for reassessment following intervening treatment by Dr. Clark.
- Received new request from Dr. Smith on August 5th.
- Consultation details include wound reassessment and updated treatment plan.
