All codes
T507
T507 – T507
OHIP Other Code · Schedule of Benefits
When to Use
- Use T507 for the initial consultation of a patient with a suspected or confirmed malignancy when the assessment requires a comprehensive history and physical examination.
- Select T507 when the patient is referred by another physician for a formal opinion on the management of a complex oncological diagnosis.
Common Pitfalls
- Billing T507 in conjunction with a minor assessment code like A007 for the same patient on the same day will result in a rejection for duplicate service.
- Submitting T507 without a valid referring physician number or a valid diagnostic code related to a neoplasm will trigger an automatic audit flag.
Billing Tips
- Ensure the referral note is dated prior to the T507 service date to satisfy the Ministry's requirement for a formal consultation request.
- If the patient requires a follow-up visit after the initial T507, transition to the appropriate subsequent visit code (e.g., A507) to avoid billing errors.
Provider Fee$112.70
Specialist Fee$135.22
Effective: February 1, 2011
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