K711 – MCC Nuclear Medicine Participant for patients requiring PET scan
OHIP Consultation & Visit Premium Codes Code — CONSULTATIONS AND VISITS · Schedule of Benefits
A multidisciplinary cancer conference (MCC) is a service conducted for the purpose of discussing and directing the management of one or more cancer patients where the physician is in attendance either in person, by telephone or videoconference as a participant or chairperson in accordance with the defined roles and minimum standards established by Ontario Health. K711 is specifically for the Nuclear Medicine specialist's participation for patients requiring a PET scan.
When to Use
- Use K711 when you are the Nuclear Medicine specialist providing expert input on the utility or interpretation of a PET scan during a formal multidisciplinary cancer conference.
- Select K711 specifically when the patient's management plan hinges on the PET scan findings and you are participating in the conference to guide that decision-making process.
Common Pitfalls
- Billing K711 alongside any other insured service, such as a consultation or assessment, for the same patient on the same day will result in a rejection.
- Failing to meet the minimum time requirements for the conference duration relative to the number of patients discussed will trigger a payment adjustment or rejection.
- Submitting K711 in conjunction with K708, K709, or K710 for the same physician on the same day is prohibited and will lead to claim denial.
Billing Tips
- Ensure your documentation explicitly links the discussion to the PET scan requirement to justify the use of K711 over the general K708 conference code.
- Maintain a log of the total conference time and the specific list of patients discussed to defend against audits regarding the pro-rated payment adjustment rules.
Effective: April 1, 2025
A. Consultations and Visits
CONSULTATIONS AND VISITS
Other
Consultations
identification of the patient and physician participants;
total time of discussion for all patients discussed; and
the outcome or decision of the case conference related to each of the patients discussed.
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