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T643

T643T643

OHIP Other Code · Schedule of Benefits

When to Use

  • Use T643 to bill for the professional component of a diagnostic imaging procedure when the technical component is performed by a facility or another provider.
  • Apply this code when submitting claims for specific radiology or diagnostic services where the physician is only responsible for the interpretation and reporting.

Common Pitfalls

  • Billing T643 in conjunction with global procedure codes that already include the professional component will trigger an automatic rejection for duplicate payment.
  • Failing to ensure the corresponding technical component has been billed by the facility can lead to audit flags regarding the completeness of the diagnostic service.

Billing Tips

  • Always verify if the service requires a specific diagnostic code or if it must be linked to a consultation code to justify the professional interpretation fee.
Provider Fee$0.00

Effective: February 1, 2011

Since Jan 2004, this fee has decreased NaN% vs 14.3% CPI inflation

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