All codes
T026
T026 – T026
OHIP Other Code · Schedule of Benefits
When to Use
- Use T026 for the initial assessment and management of a patient with a major burn injury requiring specialized care, distinct from the minor burn management covered under A001.
- Apply this code when providing comprehensive burn care services that exceed the scope of a standard consultation or minor procedure code.
Common Pitfalls
- Billing T026 in conjunction with a standard office visit code (A007) for the same encounter will trigger a rejection for duplicate service.
- Failure to include the specific burn diagnosis code or site-specific details in the claim submission often leads to manual review or rejection by the Ministry.
Billing Tips
- Ensure that the complexity of the burn management is clearly reflected in the clinical notes to justify the higher fee compared to routine wound care codes like G365.
Provider Fee$299.89
Specialist Fee$299.89
Effective: February 1, 2011
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