All codes
T928
T928 – T928
OHIP Other Code · Schedule of Benefits
When to Use
- Use T928 for the initial assessment and management of a patient presenting with a confirmed or suspected acute poisoning or toxic ingestion.
- Apply this code when the clinical encounter involves complex decision-making regarding decontamination, antidote administration, or observation for toxicological effects that exceeds the scope of a standard A007 or A003 visit.
Common Pitfalls
- Billing T928 in conjunction with a standard office visit code (e.g., A007) for the same encounter will result in a rejection for duplicate service.
- Failure to document the specific toxic agent or the clinical rationale for the intensive management required will lead to recovery during a post-payment audit.
Billing Tips
- Ensure that the clinical note explicitly details the toxicological assessment and the specific management plan to justify the higher fee compared to routine consultation codes.
Provider Fee$67.87
Specialist Fee$81.42
Effective: February 1, 2011
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