All codes
T238
T238 – T238
OHIP Other Code · Schedule of Benefits
When to Use
- Use T238 for the initial consultation of a patient with a suspected or confirmed malignancy when the assessment requires a comprehensive history and physical examination.
- Apply this code when providing a formal specialist consultation for a new oncological diagnosis that has not been previously managed by your service.
Common Pitfalls
- Do not bill T238 if a consultation (A005 or similar) has been billed for the same patient by the same physician within the preceding 12 months.
- Avoid billing T238 in conjunction with a minor assessment code on the same day, as the consultation fee is intended to cover the entire initial assessment process.
Billing Tips
- Ensure the referral source is clearly documented and valid, as T238 requires a formal written request from a referring physician or nurse practitioner to be eligible for payment.
Provider Fee$260.15
Specialist Fee$260.15
Effective: February 1, 2011
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