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T711

T711T711

OHIP Other Code · Schedule of Benefits

When to Use

  • Use T711 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 T711 when providing a formal consultation for a patient referred by another physician for a second opinion on a complex oncological management plan.
  • Apply T711 instead of A007 when the clinical complexity of the cancer diagnosis necessitates a detailed written report to the referring physician.

Common Pitfalls

  • Billing T711 for a follow-up visit or routine assessment, which must be billed under the appropriate A-code or K-code series instead.
  • Failing to ensure the referral is from a physician or nurse practitioner, as T711 is strictly a consultation code requiring a formal referral request.
  • Submitting T711 without a corresponding written consultation report in the patient record, which is a mandatory requirement for audit compliance.

Billing Tips

  • Ensure the referral date and the referring physician's billing number are accurately recorded, as missing these fields will trigger an automatic rejection.
  • Do not bill T711 in conjunction with a minor procedure code on the same day unless the procedure is unrelated to the consultation assessment.
Provider Fee$274.20
Specialist Fee$329.05

Effective: February 1, 2011

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