All codes
T686
T686 – T686
OHIP Other Code · Schedule of Benefits
When to Use
- Use T686 for the professional component of a specialized diagnostic procedure or therapeutic intervention specifically defined under this code's schedule of benefits.
- Apply this code when the service performed meets the strict complexity criteria that differentiate it from lower-valued procedural codes like T685 or T687.
Common Pitfalls
- Billing T686 in conjunction with a standard office visit code (A007) is frequently rejected unless the procedure is performed for a separate, unrelated clinical issue.
- Failure to include the mandatory diagnostic or procedural modifier required by the Schedule of Benefits will result in an automatic rejection of the claim.
Billing Tips
- Ensure the clinical notes explicitly detail the specific technical components required by the Schedule of Benefits to justify the $800.00 fee over less intensive procedural codes.
Provider Fee$800.00
Specialist Fee$800.00
Effective: February 1, 2011
Since Apr 2005, this fee has increased 0.0% vs 10.8% CPI inflation
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