All codes
T331
T331 – T331
OHIP Other Code · Schedule of Benefits
When to Use
- Use T331 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 consultation for a patient referred by another physician for the management of a complex oncological condition.
Common Pitfalls
- Billing T331 in conjunction with a minor assessment code like A007 for the same patient on the same day will trigger a rejection.
- Submitting T331 without a valid referring physician number or failing to document the referral source will result in automatic claim denial.
- Using T331 for a routine follow-up visit instead of the appropriate subsequent visit code, such as A332, is a common audit trigger.
Billing Tips
- Ensure the consultation note clearly justifies the complexity of the oncological assessment to support the higher fee compared to standard assessment codes.
- If the consultation results in a decision to perform a procedure on the same day, ensure the procedure code is billed in addition to T331, provided it is not an inclusive minor procedure.
Provider Fee$124.54
Specialist Fee$124.54
Effective: April 1, 2025
Since Jan 2004, this fee has increased 28.0% vs 58.2% CPI inflation
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.