All codes
T387
T387 – T387
OHIP Other Code · Schedule of Benefits
When to Use
- Use T387 for the initial consultation of a patient with a suspected or confirmed malignancy when a formal, written report is generated for the referring physician.
- Apply this code when the consultation involves a comprehensive review of clinical history, physical examination, and interpretation of diagnostic investigations to establish a management plan for a cancer patient.
Common Pitfalls
- Billing T387 for a follow-up visit or a subsequent review of the same condition, which should instead be billed as a repeat consultation (A007) or a subsequent visit (A005).
- Submitting T387 without a formal, dictated consultation report on file, which is a mandatory requirement for audit compliance under the Schedule of Benefits.
- Attempting to bill T387 in conjunction with a minor procedure code on the same day without clear documentation of a separate, distinct consultation service.
Billing Tips
- Ensure the referring physician's name and billing number are included on the claim to avoid automatic rejection for missing referral information.
- If the consultation exceeds the time requirements or complexity typically associated with T387, ensure the clinical note explicitly justifies the level of service provided to defend against potential Ministry reviews.
Provider Fee$283.57
Specialist Fee$283.57
Effective: April 1, 2025
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