All codes
T042
T042 – T042
OHIP Other Code · Schedule of Benefits
When to Use
- Use T042 for the initial assessment and management of a patient presenting with a major trauma requiring multidisciplinary intervention in an emergency setting.
- Apply this code when you are the lead physician coordinating the acute resuscitation phase, provided the complexity exceeds the scope of a standard A007 or A001 assessment.
Common Pitfalls
- Billing T042 in conjunction with other emergency department assessment codes like A007 for the same patient encounter will trigger an automatic rejection.
- Failing to document the specific trauma severity or the time spent in active resuscitation can lead to recovery during a post-payment audit.
Billing Tips
- Ensure the clinical record explicitly supports the 'major trauma' designation, as this code is subject to high scrutiny regarding the necessity of the premium fee compared to standard assessment codes.
Provider Fee$517.44
Specialist Fee$517.44
Effective: February 1, 2011
Since Apr 2004, this fee has increased 4.0% vs 13.4% CPI inflation
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.