All codes
T521
T521 – T521
OHIP Other Code · Schedule of Benefits
When to Use
- Use T521 for the initial consultation of a patient with a suspected or confirmed malignancy when the assessment requires a comprehensive review of diagnostic investigations and treatment planning.
- Apply this code when providing a formal consultation for a patient referred by another physician specifically for the management of a complex oncological condition.
Common Pitfalls
- Billing T521 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 T521 without a valid referring physician number or failing to meet the requirement for a written request for consultation from a primary care provider often leads to claim reversal.
Billing Tips
- Ensure the consultation note clearly documents the referral source and the clinical question posed, as this is the primary evidence required to support the T521 fee during an audit.
Provider Fee$144.21
Specialist Fee$144.21
Effective: February 1, 2011
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