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T910
T910 – T910
OHIP Other Code · Schedule of Benefits
When to Use
- Use T910 for the initial assessment and management of a patient presenting with a minor acute illness or injury that does not meet the criteria for a full office visit (A007).
- Apply this code when performing a focused, single-system examination that is less comprehensive than a standard intermediate assessment (A007) but requires more than a simple telephone consultation.
- Utilize T910 for brief follow-up visits where the clinical encounter is limited to a specific, non-complex issue that does not require the documentation depth of a full A007.
Common Pitfalls
- Billing T910 in conjunction with a full office visit (A007) on the same day for the same patient is a common cause for automatic rejection due to unbundling rules.
- Using T910 for chronic disease management or complex multi-system reviews will trigger audit flags, as these scenarios require the higher-valued A007 code.
- Failing to document the specific, limited nature of the encounter can lead to recovery during an audit if the clinical notes suggest a complexity level that warrants an A007 instead.
Billing Tips
- Ensure your clinical notes explicitly state the focused nature of the visit to justify why a higher-valued assessment code was not used.
- If the patient presents with multiple unrelated issues, upgrade the billing to A007 to accurately reflect the increased time and complexity of the encounter.
Provider Fee$35.60
Specialist Fee$42.72
Effective: November 1, 2017
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