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Billing code

A246A — Otolaryngology repeat consultation

ENT repeat consultation

An otolaryngologist bills A246 for another consultation on the same problem after another physician cared for the patient in between.

Watch for: Needs a new written referral with the referrer's billing number on the claim; otherwise it pays as a specific assessment.

Code

A246A

Description

Otolaryngology 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

Repeat consultation by the same otolaryngologist for the same problem after another physician has cared for the patient in between.

What it covers

A repeat consultation is an additional consultation by the same consultant for the same presenting problem, after care by another physician in the interval 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 (GP19).

Billing rules

• Specialists bill from the Consultations and Visits listing of their own specialty (GP9).
• Needs a new written referral; missing elements reduce it to a lesser assessment (GP16, GP19).
• If the repeat consultation requirements aren't met, it pays as a specific assessment (GP18).
• Repeat consultations don't count toward the consultation limits (GP18).
• Patients under 16 get the specialist consultation age premium (GP64).
• Detention (K001) may start only after 60 minutes (GP29–GP31).
• Can be done by video only (not phone) with an existing relationship; add K300A (AJ2, A66, A70).

Often billed with

• Z296 flexible fiberoptic nasal endoscopy (GP4, P1).

Common rejections

• ARF: OHIP describes this as 'Missing physician referring number': a consultation needs the referring physician's or NP's billing number from the written request (GP16).
• AT3: Billed as virtual care (K300A/K301A) and OHIP found no existing patient-physician relationship, such as an in-person service by you in the past 24 months (A66).
• AT2: OHIP describes this as 'Must include video modality': this code is video only for virtual care, so it can't be billed by telephone (K301A) (AJ2).

Related codes: A245, A243, A244, C246

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Otolaryngology (24), page A166.

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