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T581

T581T581

OHIP Other Code · Schedule of Benefits

When to Use

  • Use T581 for the initial consultation of a patient with a suspected or confirmed malignancy when the assessment requires a comprehensive review of diagnostic investigations.
  • Select T581 when providing a formal specialist opinion for a complex oncological case that does not meet the criteria for a more specific diagnostic or procedural code.

Common Pitfalls

  • Billing T581 in conjunction with a minor assessment code like A007 for the same patient on the same day will trigger an automatic rejection.
  • Submitting T581 without a valid referring physician number or failing to include the required diagnostic code for the malignancy will result in a claim error.

Billing Tips

  • Ensure the consultation note explicitly details the oncological focus to justify the specialist fee over a standard A005 or A007 assessment.
Provider Fee$91.00
Specialist Fee$91.00

Effective: February 1, 2011

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