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T583
T583 – T583
OHIP Other Code · Schedule of Benefits
When to Use
- Use T583 for the initial consultation of a patient with a confirmed diagnosis of a malignant neoplasm when a comprehensive assessment and management plan are required.
- Select T583 when the patient is referred by another physician specifically for the management of a complex oncological condition that necessitates a detailed review of diagnostic investigations.
Common Pitfalls
- Billing T583 in conjunction with a minor assessment code like A007 is a common rejection trigger, as the consultation fee is intended to be all-inclusive for the visit.
- Submitting T583 without a valid referring physician number or failing to document the referral source will result in an automatic claim rejection.
Billing Tips
- Ensure the clinical note explicitly justifies the complexity of the consultation to support the T583 fee if audited against lower-valued assessment codes.
Provider Fee$268.30
Specialist Fee$268.30
Effective: February 1, 2011
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