All codes
T569
T569 – T569
OHIP Other Code · Schedule of Benefits
When to Use
- Use T569 for the formal consultation of a patient with a suspected or confirmed diagnosis of a complex hematological malignancy requiring comprehensive review.
- Apply this code when providing a formal written consultation report to the referring physician for a new patient referral that meets the criteria for a major complex assessment.
Common Pitfalls
- Billing T569 for a follow-up visit or a routine review of stable chronic conditions, which should instead be billed under A005 or equivalent assessment codes.
- Submitting T569 without a corresponding formal consultation report on file, as this is a requirement for all consultation-level billing codes.
- Attempting to bill T569 in conjunction with a minor procedure code on the same day without clear documentation of the separate nature of the consultation.
Billing Tips
- Ensure the referral request is documented and the consultation report is sent to the referring physician to satisfy the audit requirements for a specialist consultation.
- If the patient requires a subsequent visit for the same condition, transition to the appropriate follow-up assessment code rather than repeating T569.
Provider Fee$742.50
Specialist Fee$742.50
Effective: February 1, 2011
Since Apr 2005, this fee has increased 0.0% vs 10.8% CPI inflation
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