All codes
T707
T707 – T707
OHIP Other Code · Schedule of Benefits
When to Use
- Use T707 for the initial consultation of a patient with a suspected or confirmed malignancy when the patient has not been previously seen by you for this specific condition.
- Apply this code when providing a comprehensive assessment for a new cancer diagnosis, as it offers a higher premium than a standard A005 consultation.
- Select T707 when the complexity of the oncological workup requires a detailed review of pathology, imaging, and staging that exceeds the scope of a routine specialist consultation.
Common Pitfalls
- Billing T707 for a follow-up visit or a second opinion on a patient already under your care for the same malignancy will result in a rejection; use a repeat consultation or assessment code instead.
- Submitting T707 without a formal written consultation report sent to the referring physician is a common cause for audit recovery.
- Attempting to bill T707 in conjunction with a minor procedure code on the same day often triggers a manual review or rejection unless the procedure is clearly distinct and medically necessary.
Billing Tips
- Ensure the referring physician's billing number is included in the claim, as T707 requires a valid referral to be processed correctly.
- If the patient has multiple primary malignancies, document the specific diagnosis being addressed in the consultation note to justify the use of T707 over a standard consultation code.
Provider Fee$171.30
Specialist Fee$205.50
Effective: February 1, 2011
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