Billing code
C476A — Respiratory disease repeat consultation – hospital in-patient
Respirology in-patient repeat consultation
Bill for another respirology consultation on the same problem for a hospital in-patient after another physician cared for them in between.
Watch for: Needs a new written request with the referrer's billing number; otherwise it pays as an assessment.
| Provider | Specialist | Assistant | Anaesthetist | Non-anaesthetist |
|---|---|---|---|---|
| $0.00 | $115.30 | $0.00 | $0.00 | $0.00 |
- Code
- C476A
- Description
- Respiratory disease repeat consultation – hospital in-patient
- 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 a respirologist for a hospital in-patient, for the same problem after another physician has cared for the patient.
What it covers
C476 is a repeat consultation by a specialist in Respiratory Disease for a non-emergency hospital in-patient (A199).
A repeat consultation is another consultation by the same consultant for the same presenting problem after another physician has cared for the patient in the interval (GP19).
Billing rules
- Needs a new written request from the referring physician or nurse practitioner (GP19, GP16).
- If the repeat consultation rules aren't met, it pays as an assessment (GP18).
- Repeat consultations don't count toward the consultation limits (GP18).
- Virtual care: video only, not phone (AJ2). For an in-patient you must not be the MRP, the hospital must lack a local physician with the expertise (documented by the referrer), and for a consultation the referrer must have seen the patient in person within 30 days (A69).
Common rejections
- ARF: OHIP's message is 'Missing Physician Referring Number': a consultation needs a written request from a physician or nurse practitioner, and the referrer's billing number must be on the claim (GP16).
- AT2: OHIP's message is 'Must Include Video Modality': this code is on the video-only list, so a phone claim (K301A) is refused (AJ2).
Related codes: A476, C475, C575, C470, C474
Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Respiratory Disease (47), page A199. Rules GP16–GP19.
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