All codes
T592
T592 – T592
OHIP Other Code · Schedule of Benefits
When to Use
- Use T592 for the initial consultation of a patient with a suspected or confirmed malignancy when the assessment requires a comprehensive history and physical examination.
- Apply this code when the patient is referred by another physician for a formal opinion on the management of a malignant condition, provided the patient has not been seen by you for the same condition in the previous 12 months.
Common Pitfalls
- Billing T592 when the patient has been seen by you or a partner in the same group for the same diagnosis within the last year, which triggers a rejection for a repeat consultation.
- Submitting T592 without a valid referring physician number, as this code strictly requires a formal referral to be eligible for payment.
- Attempting to bill T592 in conjunction with a minor procedure performed on the same day, which will result in the consultation being reduced or rejected.
Billing Tips
- Ensure the referral date is clearly documented and matches the date provided in the claim to avoid 'referral not found' rejections.
- If the patient requires a follow-up visit after the T592 consultation, transition to the appropriate subsequent visit code (e.g., A005) to ensure continued payment eligibility.
Provider Fee$106.53
Specialist Fee$106.53
Effective: February 1, 2011
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