All codes
T637
T637 – T637
OHIP Other Code · Schedule of Benefits
When to Use
- Use T637 for the initial consultation of a patient with a suspected or confirmed malignancy when the assessment requires a comprehensive review of complex diagnostic data.
- Apply this code when the consultation is requested by another physician and involves a detailed evaluation that exceeds the scope of a standard A005 or A007 assessment.
Common Pitfalls
- Billing T637 for a follow-up visit instead of a subsequent visit code like A637, which will trigger an automatic rejection or audit flag.
- Submitting T637 without a formal written request from a referring physician, as this is a mandatory requirement for all consultation codes.
Billing Tips
- Ensure the consultation note clearly documents the referring physician's name and the specific clinical question to satisfy the Ministry's audit requirements for specialist consultations.
Provider Fee$232.75
Specialist Fee$232.75
Effective: February 1, 2011
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