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T505

T505T505

OHIP Other Code · Schedule of Benefits

When to Use

  • Use T505 for the initial consultation and assessment of a patient with a confirmed diagnosis of malignant neoplasm when the service is provided by a radiation oncologist.
  • Apply this code when performing a comprehensive oncological evaluation that includes the review of diagnostic imaging, pathology reports, and the development of a complex radiation treatment plan.

Common Pitfalls

  • Billing T505 in conjunction with a standard A007 or A005 assessment code for the same patient on the same day will result in a rejection for duplicate service.
  • Failing to document the specific radiation oncology consultation requirements can lead to recovery during an audit, as this code carries a higher premium than standard specialist consultation codes.

Billing Tips

  • Ensure the referral source is clearly documented in the chart, as T505 is strictly a consultation code requiring a formal request from another physician or nurse practitioner.
Provider Fee$292.22
Specialist Fee$292.22

Effective: February 1, 2011

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