< Billing codes

Billing code

A086A — Repeat Consultation

Plastic surgery repeat consultation

A plastic surgeon bills A086 for a second consultation on the same problem after another physician cared for the patient, on a new referral.

Watch for: Needs a new written, signed request naming the referrer and billing number, and only the Plastic Surgery specialty can bill it.

Code

A086A

Description

Repeat Consultation

FHO+ basket

Not in the FHO+ base rate basket (Schedule 2 or 2B).

Effective date

Apr 1, 2026

Termination date

No end date

Explanation

Updated October 26, 2026

Plastic Surgery (08) repeat consultation: a second consultation for the same problem after another physician cared for the patient, on a new referral.

What it covers

A086 is the Plastic Surgery (08) repeat consultation (A181). A repeat consultation is an additional consultation by the same consultant for the same presenting problem, after another physician has cared for the patient since the first consultation (GP19).

It has the same requirements as a consultation, including a new written request from the referring physician, nurse practitioner or dental surgeon and a written report back (GP16, GP19).

Billing rules

• Needs a new written, signed request naming the consultant or specialty, the referrer and billing number, and the patient and health number, kept in the chart (GP16, GP19).
• If the repeat consultation requirements aren't met, it is paid as a general or specific assessment, depending on the specialty (GP17, GP18).
• Not counted in the consultation limits of one per two consecutive 12-month periods (GP18).
• A same-day Z-prefix procedure (IOP) is payable in addition to the consultation. If the major pre-operative visit was in the previous 12 months, only a partial assessment (A084) is payable the same day before the IOP (GP4, SP4).
• Detention (K001) can only start after 60 minutes (GP30).
• Patients under 16: specialist consultation age premium of 10% to 30% (GP64).
• Video only (with K300A), never telephone (AJ2).

Often billed with

• Z101 abscess drainage, Z130 radical nail excision or Z160 removal of two lesions by electrocoagulation and/or curetting: IOPs payable in addition to the consultation (GP4, M1, M3, M23).
• E542 when Z101 or Z130 is done outside hospital; E542 is listed under both, but not for removal by electrocoagulation and/or curetting (Z159 to Z161) (M1, M3, M23).

Common rejections

• A4D: The code is in the Plastic Surgery (08) listing, and specialists bill consultations from their own specialty's listing (GP9). The specialty on the claim can't bill it; a general surgeon, for example, bills A036.

Related codes: A085, A935, A083, A084, C086

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Plastic Surgery (08), page A181; General Preamble GP16 to GP19 (consultations, repeat consultation); Surgical Preamble SP4; Integumentary System Surgical Procedures M1, M3 and M23

APEX checks every paid claim against the Schedule of Benefits and flags codes billed below what the visit qualified for. See how APEX works · Pricing