All codes
T712
T712 – T712
OHIP Other Code · Schedule of Benefits
When to Use
- Use T712 for the formal consultation of a patient referred by another physician for a comprehensive assessment of a complex clinical problem.
- Select T712 when the consultation requires a detailed review of records, a comprehensive physical examination, and a written report back to the referring physician.
- Use T712 instead of A007 when the patient meets the criteria for a formal consultation and the service is not a routine follow-up or repeat visit.
Common Pitfalls
- Billing T712 for a patient who has been seen by you for the same condition within the previous 12 months, which should be billed as a repeat consultation or assessment.
- Failing to ensure a formal written referral request is on file, as T712 is ineligible for payment without a documented referral from another physician or nurse practitioner.
- Submitting T712 when the service provided was merely a minor assessment or a visit that does not meet the complexity requirements of a full consultation.
Billing Tips
- Ensure the referring physician's billing number is included in the claim to avoid automatic rejection of the consultation fee.
- If the consultation results in a decision to perform a procedure, you may bill the consultation fee in addition to the procedure fee, provided the consultation was not solely for the purpose of scheduling the procedure.
Provider Fee$325.70
Specialist Fee$390.80
Effective: February 1, 2011
Since Jan 2004, this fee has increased 0.0% vs 14.3% CPI inflation
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