All codes
T419
T419 – T419
OHIP Other Code · Schedule of Benefits
When to Use
- Use T419 for the initial consultation of a patient with a suspected or confirmed malignancy when referred by another physician or nurse practitioner.
- Apply this code when the clinical assessment requires a comprehensive review of diagnostic investigations and the development of a complex multi-modal treatment plan for a new cancer diagnosis.
Common Pitfalls
- Billing T419 in conjunction with a minor assessment code like A007 for the same patient on the same day will trigger a rejection for duplicate service.
- Submitting T419 without a valid referring physician number or failing to include the required consultation report will result in automatic claim rejection.
Billing Tips
- Ensure the consultation report is sent to the referring physician within 48 hours, as this is a mandatory requirement for the T419 fee to be considered valid during an audit.
Provider Fee$203.78
Specialist Fee$203.78
Effective: April 1, 2025
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