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T591
T591 – T591
OHIP Other Code · Schedule of Benefits
When to Use
- Use T591 for the initial consultation of a patient referred for a formal assessment of a suspected or confirmed malignancy.
- Apply this code when the consultation involves a comprehensive review of diagnostic imaging or pathology reports to establish a cancer management plan.
- Select T591 instead of A005 when the referral specifically requests an oncology-focused evaluation rather than a general internal medicine consultation.
Common Pitfalls
- Billing T591 for a follow-up visit instead of the appropriate subsequent visit code, which will trigger an automatic rejection.
- Submitting T591 without a valid referring physician number, as this code strictly requires a formal referral to be eligible for payment.
- Attempting to bill T591 on the same day as a minor procedure code that is considered inclusive of the consultation fee.
Billing Tips
- Ensure the referral note explicitly mentions the suspicion of malignancy to justify the use of the T-series consultation code over standard A-codes.
- If the consultation exceeds the time threshold, consider if the complexity warrants a time-based consultation code, though T591 remains the standard for oncology referrals.
Provider Fee$44.61
Specialist Fee$53.59
Effective: February 1, 2011
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