Billing code
C086A — In-patient repeat consultation – plastic surgery
Plastic surgery in-patient repeat consultation
Bill C086 when the same plastic surgeon consults again on an in-patient's same problem after another physician's care in between.
Watch for: Needs a new written request; if repeat consultation requirements aren't met, it is paid as an assessment.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $0.00 | $62.80 | $0.00 | $0.00 | $0.00 |
- Code
- C086A
- Description
- In-patient repeat consultation – plastic surgery
- 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 plastic surgery consultation for a hospital in-patient: same problem, after another physician's care, with a new referral.
What it covers
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).
C086 is the non-emergency hospital in-patient listing for plastic surgery (A181).
Billing rules
- Needs a new written request from the referring physician, nurse practitioner or dental surgeon, like any consultation (GP19).
- If the repeat consultation requirements aren't met, it is paid as an assessment (GP18).
- Repeat consultations don't count toward the consultation limits (GP18).
- Age premiums apply for patients under 16, from 10% to 30% by age (GP64).
- By video only (not phone), and for in-patients only if you aren't the MRP, no local physician with the expertise is available (documented by the referrer), and the referrer assessed the patient in person within the prior 30 days (Appendix J, A69).
- For emergency calls and other special visits to in-patients, use the general listings (A-prefix) with special visit premiums instead (A181, GP65–GP78).
Common rejections
- ARF: OHIP describes this as 'Missing Physician Referring Number'. A consultation is paid only on a written referral from a physician or nurse practitioner (GP16); enter the referrer's billing number.
Related codes: C085, C935, C083, C084, A086, W086
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Plastic Surgery (08), page A181; rules GP19.
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