All codes
T273
T273 – T273
OHIP Other Code · Schedule of Benefits
When to Use
- Use T273 for the initial consultation of a patient with a suspected or confirmed malignancy when the assessment requires a comprehensive review of diagnostic investigations.
- Apply this code when providing a formal consultation for a patient referred by another physician to determine the staging or management plan for a solid tumor.
Common Pitfalls
- Billing T273 in conjunction with a minor assessment code like A007 for the same patient on the same day will result in a rejection for duplicate service.
- Submitting T273 without a valid referring physician billing number or a valid referring facility code will trigger an automatic claim rejection.
Billing Tips
- Ensure the consultation note clearly documents the referral source and the specific clinical question asked, as this is the primary audit trigger for T273 claims.
Provider Fee$195.16
Specialist Fee$195.16
Effective: February 1, 2011
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