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T025
T025 – T025
OHIP Other Code · Schedule of Benefits
When to Use
- Use T025 for the initial assessment and management of a patient presenting with a major burn injury requiring specialized care.
- Apply this code when the patient meets the criteria for a major burn, typically involving significant total body surface area (TBSA) or specific anatomical involvement requiring immediate specialist intervention.
Common Pitfalls
- Billing T025 in conjunction with a standard office visit code (A007) is considered unbundling and will result in a rejection.
- Failure to document the specific TBSA percentage and depth of the burn in the patient record is a primary cause for audit recovery.
- Attempting to bill T025 for minor burn care that should instead be managed under a standard minor assessment code or procedural fee.
Billing Tips
- Ensure the clinical record explicitly justifies the complexity of the burn to support the high-value fee associated with T025 during an audit.
- Verify that no other major procedural codes for the same burn management are billed on the same day unless they are explicitly permitted as add-ons to the assessment.
Provider Fee$600.73
Specialist Fee$600.73
Effective: February 1, 2011
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