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T391

T391T391

OHIP Other Code · Schedule of Benefits

When to Use

  • Use T391 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 performing a formal oncology consultation that exceeds the complexity of a standard A005 or A007 assessment.

Common Pitfalls

  • Billing T391 for a follow-up visit instead of a subsequent visit code, which will trigger an automatic rejection or audit flag.
  • Submitting T391 without the required referring physician billing number, as this is a mandatory field for all consultation codes.

Billing Tips

  • Ensure the consultation note clearly documents the referral source and the specific clinical question to justify the higher fee compared to standard assessment codes.
Provider Fee$220.33
Specialist Fee$220.33

Effective: April 1, 2025

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