A760 – Complex Endocrine Neoplastic Disease Assessment
OHIP General Listings Code — Endocrinology & Metabolism (15) · Schedule of Benefits
This service is an assessment in relation to one or more of the following diseases where the complexity of the condition requires the ongoing management by an endocrinologist: thyroid neoplasm, parathyroid neoplasm, pituitary neoplasm, or adrenal neoplasm.
When to Use
- Bill A760 for an endocrinologist's assessment of a patient with a newly diagnosed, complex pituitary adenoma requiring ongoing specialized management.
- Use A760 when managing a patient with a known, aggressive thyroid carcinoma that has metastasized and requires complex, multi-system assessment and management by an endocrinologist.
- A760 is appropriate for assessing a patient with a recurrent parathyroid adenoma causing significant hypercalcemia and requiring complex endocrine management beyond routine follow-up.
Common Pitfalls
- Billing A760 for routine follow-up of uncomplicated benign thyroid nodules or simple goiters, which are not considered complex neoplastic diseases.
- Submitting A760 for patients with endocrine disorders not related to neoplasms (e.g., simple diabetes management, uncomplicated hypothyroidism), as the code specifically targets neoplastic conditions.
- Exceeding the usage limit of 6 per patient per 12 months or 12 per patient per 24 months without clear justification for continued complex management, risking fee adjustment.
Billing Tips
- Ensure the patient's diagnosis code clearly reflects a thyroid, parathyroid, pituitary, or adrenal neoplasm to support the A760 claim.
- Document a comprehensive history and physical examination specific to the neoplastic endocrine condition, demonstrating the complexity requiring specialist management.
Effective: June 1, 2025
Consultations and Visits
Endocrinology & Metabolism (15)
Consultations and Visits
Assessment
The service must include the elements of a medical specific re-assessment (full, relevant history and physical examination of one or more systems).
A760 is not payable for the evaluation and/or management of uncomplicated endocrine disorders.
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