All codes
T811
T811 – T811
OHIP Other Code · Schedule of Benefits
When to Use
- Use T811 as a mandatory administrative placeholder when submitting a claim for a procedure that requires a manual override or specific adjustment that cannot be processed via standard fee codes.
- Apply this code when linking a secondary service or specific diagnostic test that requires a zero-dollar or nominal value to satisfy the claims processing system's validation requirements.
Common Pitfalls
- Billing T811 as a standalone service will trigger an automatic rejection because it lacks the necessary clinical complexity associated with standard consultation or assessment codes like A007.
- Overusing T811 in place of valid diagnostic or procedural codes will flag your provider profile for an audit due to the discrepancy between the billed code and the documented clinical activity.
Billing Tips
- Ensure T811 is only appended to a primary claim as a supporting code, as it is not intended to generate revenue but rather to facilitate the technical processing of complex claims.
Provider Fee$0.01
Specialist Fee$0.01
Effective: March 1, 2007
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