All codes
T412
T412 – T412
OHIP Other Code · Schedule of Benefits
When to Use
- Use T412 for the initial consultation of a patient with a suspected or confirmed malignancy when the service is provided by a specialist in internal medicine or a related subspecialty.
- Select T412 instead of A005 when the patient requires a comprehensive oncological assessment that exceeds the scope of a standard intermediate assessment.
Common Pitfalls
- Billing T412 in conjunction with a minor procedure code on the same day often triggers a rejection unless the procedure is medically necessary and distinct from the consultation.
- Submitting T412 for a follow-up visit is a frequent audit trigger; use subsequent visit codes like A007 instead for established patients.
Billing Tips
- Ensure the referral source is clearly documented and valid, as T412 requires a formal referral from another physician or nurse practitioner to be eligible for payment.
Provider Fee$48.90
Specialist Fee$48.90
Effective: April 1, 2025
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