All codes
T342
T342 – T342
OHIP Other Code · Schedule of Benefits
When to Use
- Use T342 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 requested by another physician for a patient with a complex oncological presentation that exceeds the scope of a standard A005 or A007 assessment.
Common Pitfalls
- Billing T342 for a follow-up visit instead of using the appropriate subsequent visit code, which will trigger an automatic rejection or audit recovery.
- Submitting T342 without a valid referring physician number or failing to document the formal request for consultation in the patient record.
Billing Tips
- Ensure the consultation note clearly documents the clinical question posed by the referring physician to satisfy the requirements for a formal consultation versus a simple transfer of care.
- If the patient requires a procedure on the same day, ensure the T342 is billed with the appropriate diagnostic code and consider if a premium code applies to the surgical component.
Provider Fee$263.30
Specialist Fee$263.30
Effective: February 1, 2011
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.