All codes
T703
T703 – T703
OHIP Other Code · Schedule of Benefits
When to Use
- Use T703 for the initial consultation of a patient with a suspected or confirmed malignancy when the assessment requires a comprehensive review of complex diagnostic data.
- Select T703 when the clinical complexity of a new cancer diagnosis necessitates a detailed discussion of treatment options, prognosis, and multidisciplinary care planning that exceeds the scope of a standard A005 or A007 consultation.
Common Pitfalls
- Billing T703 for follow-up visits or routine monitoring; this code is strictly for the initial consultation and cannot be used for subsequent assessments.
- Submitting T703 without a formal referral from another physician, which will result in an automatic rejection by the Ministry.
- Failing to include the referring physician's billing number on the claim, which is a mandatory requirement for all consultation codes.
Billing Tips
- Ensure the clinical note explicitly justifies the complexity of the consultation to support the higher fee compared to a standard A005 consultation.
- If the consultation occurs in an emergency department, ensure the claim is submitted with the appropriate diagnostic code to avoid conflict with hospital-based billing rules.
Provider Fee$239.60
Specialist Fee$287.60
Effective: February 1, 2011
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