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T701

T701T701

OHIP Other Code · Schedule of Benefits

When to Use

  • Use T701 for the initial consultation of a patient with a suspected or confirmed malignancy when a comprehensive assessment is required.
  • Select T701 when the patient has been referred by another physician for a formal opinion on the management of a complex oncological condition.
  • Use T701 instead of A005 when the complexity of the cancer diagnosis warrants a higher-level specialist consultation fee.

Common Pitfalls

  • Billing T701 for a follow-up visit instead of a consultation; follow-ups must be billed using the appropriate assessment code like A007.
  • Failing to include the referring physician's billing number on the claim, which will trigger an automatic rejection.
  • Attempting to bill T701 in conjunction with a minor procedure code on the same day without clear documentation of a separate, distinct clinical encounter.

Billing Tips

  • Ensure the consultation report is sent to the referring physician within the required timeframe to substantiate the claim during a potential audit.
  • If the consultation results in a decision to perform a procedure, ensure the procedure is billed separately using the appropriate surgical fee code.
Provider Fee$171.30
Specialist Fee$205.50

Effective: February 1, 2011

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