All codes
T406
T406 – T406
OHIP Other Code · Schedule of Benefits
When to Use
- Use T406 for the initial assessment and management of a patient presenting with a major burn injury requiring specialized care.
- Apply this code when performing a comprehensive evaluation of burn depth, surface area, and systemic impact that exceeds the scope of a standard A007 or A005 consultation.
Common Pitfalls
- Billing T406 in conjunction with a standard consultation code (A007) for the same patient encounter will trigger an automatic rejection for duplicate services.
- Failing to document the total body surface area (TBSA) percentage and burn classification, which are mandatory requirements to justify the higher fee associated with T406.
Billing Tips
- Ensure the clinical notes clearly delineate the complexity of the burn injury to support the T406 fee over lower-tier assessment codes.
Provider Fee$386.24
Specialist Fee$386.24
Effective: April 1, 2025
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