All codes
T101
T101 – T101
OHIP Other Code · Schedule of Benefits
When to Use
- Use T101 for the initial consultation of a patient with a confirmed diagnosis of malignant neoplasm when the service includes a comprehensive review of records and a detailed treatment plan.
- Apply T101 when providing a formal consultation for a patient referred by another physician for the management of a complex oncology case that requires multidisciplinary coordination.
Common Pitfalls
- Billing T101 in conjunction with a minor assessment code like A007 is a common rejection trigger, as T101 is intended to be a standalone comprehensive consultation.
- Submitting T101 without a valid referring physician number will result in an automatic rejection, as this code strictly requires a formal referral.
Billing Tips
- Ensure the referral note is dated prior to the T101 service date to avoid audit flags regarding the validity of the consultation request.
- If the patient requires subsequent visits after the T101 consultation, transition to the appropriate follow-up assessment codes rather than attempting to bill T101 again for the same episode of care.
Provider Fee$307.20
Specialist Fee$307.20
Effective: February 1, 2011
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