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T234

T234T234

OHIP Other Code · Schedule of Benefits

When to Use

  • Use T234 for the initial consultation of a patient with a confirmed diagnosis of a malignant neoplasm requiring complex multidisciplinary planning.
  • Apply this code when the clinical assessment involves a comprehensive review of diagnostic imaging and pathology reports that necessitates a formal treatment plan discussion.

Common Pitfalls

  • Billing T234 in conjunction with a standard office visit code (A007) for the same patient on the same day will result in a rejection for duplicate service.
  • Failure to include the mandatory diagnostic code representing the malignant neoplasm will lead to an automatic claim rejection.

Billing Tips

  • Ensure the referral source is clearly documented in the claim submission, as T234 requires a valid referring physician number to be processed successfully.
Provider Fee$311.75
Specialist Fee$311.75

Effective: February 1, 2011

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