All codes
T031
T031 – T031
OHIP Other Code · Schedule of Benefits
When to Use
- Use T031 for the initial consultation of a patient with a suspected or confirmed malignancy when the assessment requires a comprehensive review of complex diagnostic data.
- Apply this code when the consultation is requested by another physician and involves a formal written report, distinguishing it from a standard A005 or A007 assessment.
Common Pitfalls
- Billing T031 for a follow-up visit or a subsequent consultation within the same 12-month period for the same condition, which should be billed under a repeat consultation or minor assessment code.
- Failing to ensure the referring physician's billing number is included in the claim, which will result in an automatic rejection by the Ministry.
Billing Tips
- Ensure your documentation explicitly reflects the complexity of the oncological assessment to justify the higher fee compared to standard consultation codes like A013.
Provider Fee$310.52
Specialist Fee$310.52
Effective: February 1, 2011
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