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T614
T614 – T614
OHIP Other Code · Schedule of Benefits
When to Use
- Use T614 for the initial consultation of a patient with a suspected or confirmed malignancy when the service meets the criteria for a comprehensive oncology assessment.
- Select T614 when the complexity of the cancer diagnosis requires a detailed review of pathology, staging, and multidisciplinary treatment planning that exceeds the scope of a standard A005 consultation.
Common Pitfalls
- Billing T614 in conjunction with a minor procedure or a routine follow-up visit, which will trigger an automatic rejection for unbundling.
- Failing to include the mandatory referring physician information, which is a strict requirement for all consultation-level billing in the Schedule of Benefits.
Billing Tips
- Ensure the clinical note explicitly documents the consultation request and the specific oncological complexity to justify the higher fee compared to a standard consultation code.
Provider Fee$329.20
Specialist Fee$329.20
Effective: February 1, 2011
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