All codes
T629
T629 – T629
OHIP Other Code · Schedule of Benefits
When to Use
- Use T629 for the initial consultation of a patient referred for a complex diagnostic assessment of a suspected neurological or systemic condition.
- Apply this code when the clinical encounter requires a comprehensive review of systems and diagnostic workup that exceeds the scope of a standard A005 or A007 assessment.
Common Pitfalls
- Billing T629 in conjunction with a minor assessment code on the same day is frequently rejected; ensure the complexity of the service justifies the higher fee.
- Failing to include a valid referring physician number on the claim will result in an automatic rejection by the Ministry.
Billing Tips
- Ensure the clinical documentation clearly supports the 'complex' nature of the assessment to withstand potential post-payment audits regarding the necessity of the T629 fee.
Provider Fee$111.48
Specialist Fee$111.48
Effective: February 1, 2011
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