Billing code
A160A — Comprehensive Nephrology Consultation
Long nephrology consultation
A nephrologist bills A160 for a full consultation with at least 75 minutes of direct patient contact.
Watch for: Record start and stop times in the chart, or it pays a lesser fee; bill under the Nephrology (16) specialty.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $0.00 | $342.25 | $0.00 | $0.00 | $0.00 |
- Code
- A160A
- Description
- Comprehensive Nephrology 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
Comprehensive nephrology consultation: a full consultation by a nephrologist with at least 75 minutes of direct contact. Start and stop times required.
What it covers
A160 is a consultation by a specialist in nephrology who provides all the elements of a consultation and spends at least 75 minutes in direct contact with the patient, not counting other separately billable services (A136).
It must meet every consultation requirement: a written request from the referring physician or nurse practitioner, and a written report back (A136, GP16). The 75 minutes excludes non-patient-facing time such as reviewing charts or imaging and documentation (A136).
Billing rules
- Start and stop times must be in the chart, or the service is paid at a lesser fee (A136).
- Needs a written, signed request naming the consultant or specialty, the referrer and billing number, and the patient and health number, kept in the chart; otherwise it is paid as a lesser assessment (GP16).
- The consultation limits apply to comprehensive consultations: same patient and diagnosis, one per two consecutive 12-month periods; unrelated diagnosis, one per 12 months (GP17, GP18).
- A160 needs at least 75 minutes of direct contact; the nephrology consultation without a time minimum is A165 (A136).
- Detention (K001) can only start after 120 minutes (GP31).
- Patients under 16: specialist consultation age premium of 10% to 30% (GP64).
- Video only (with K300A), never telephone (AJ2). For hospital in-patients bill C160, with the same conditions (A137).
Common rejections
- EQE: The physician wasn't registered in the group on the claim on the service date. A registration issue, not a coding one.
- EQ2: The specialty code on the claim wasn't registered and active for the physician on the service date. A160 is in the Nephrology (16) listing; correct the specialty, or update the registration, then resubmit.
- AC4: The referring provider number was missing, mistyped, your own number, or from a provider type that can't refer for this code. Enter the referrer's six-digit number from the request.
Related codes: A165, A865, A166, A163, C160
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Nephrology (16), pages A136 to A137; General Preamble GP16 to GP18 (consultations)
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