All codes
T271
T271 – T271
OHIP Other Code · Schedule of Benefits
When to Use
- Use T271 for the initial consultation of a patient with a suspected or confirmed malignancy when the assessment requires a comprehensive review of diagnostic investigations and treatment planning.
- Apply this code when the patient is referred by another physician for a formal opinion on management of a neoplastic condition, provided the requirements for a consultation are met.
Common Pitfalls
- Billing T271 as a repeat consultation when the patient has been seen by the same physician or a partner in the same group for the same condition within the preceding 12 months; use a follow-up visit code instead.
- Submitting T271 without a valid referring physician number or failing to document the referral request, which will trigger an automatic rejection.
- Attempting to bill T271 in conjunction with a minor procedure code on the same day without justifying the separate nature of the consultation.
Billing Tips
- Ensure the clinical note explicitly details the referral source and the specific clinical question asked to satisfy the Ministry's definition of a consultation.
- If the consultation results in a decision to perform a procedure, ensure the consultation note is distinct from the operative report to avoid claims being flagged for bundling.
Provider Fee$118.47
Specialist Fee$118.47
Effective: February 1, 2011
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