All codes
T622
T622 – T622
OHIP Other Code · Schedule of Benefits
When to Use
- Use T622 for the initial consultation of a patient referred for a complex assessment of a specific condition that requires a comprehensive report, distinguishing it from a standard A005 or A007 assessment.
- Apply T622 when the clinical complexity of the patient's presentation exceeds the scope of a standard office visit, provided the requirements for a formal consultation are met.
Common Pitfalls
- Billing T622 without a valid written referral from a primary care physician or authorized practitioner will result in an automatic rejection.
- Submitting T622 for a patient who has been seen by you or a partner in the same group for the same diagnosis within the previous 12 months is a common cause for audit recovery.
Billing Tips
- Ensure the consultation report is sent back to the referring physician within the required timeframe, as failure to do so can lead to clawbacks during an audit.
- If the patient requires a follow-up, switch to the appropriate follow-up code (e.g., A006) rather than attempting to bill T622 again for the same episode of care.
Provider Fee$168.40
Specialist Fee$168.40
Effective: February 1, 2011
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