All codes
T335
T335 – T335
OHIP Other Code · Schedule of Benefits
When to Use
- Use T335 for the initial consultation of a patient referred for a formal assessment of a suspected or confirmed malignant neoplasm.
- Apply this code when the clinical encounter requires a comprehensive review of diagnostic imaging and pathology reports to establish a staging or treatment plan for a cancer diagnosis.
Common Pitfalls
- Billing T335 for a routine follow-up visit instead of a consultation code, which will trigger a rejection if the patient has been seen by the same physician for the same condition within the preceding 12 months.
- Failing to include the referring physician's billing number on the claim, as this is a mandatory requirement for all consultation codes in Ontario.
Billing Tips
- Ensure the consultation request is documented in the patient chart, as T335 requires a formal written or verbal referral from another physician or nurse practitioner to be valid.
Provider Fee$126.40
Specialist Fee$126.40
Effective: February 1, 2011
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