A338 – Minor Assessment
OHIP General Listings Code — Diagnostic Radiology (33) · Schedule of Benefits
A minor assessment (A338) is the service rendered when a radiologist evaluates a patient on a non-emergent basis on the advisability of performing a diagnostic radiological procedure which eventually is not done.
When to Use
- A patient is referred for a CT scan of the abdomen, but after a brief history and physical examination, the radiologist determines the symptoms are likely due to a musculoskeletal issue, and the CT scan is not performed.
- A referring physician requests an MRI of the lumbar spine for non-specific back pain. The radiologist reviews the request, performs a brief assessment, and concludes that conservative management is more appropriate, deferring the MRI.
- A patient presents for a planned X-ray of the knee. Following a discussion and assessment, the radiologist advises that the X-ray is not indicated at this time due to the patient's age and lack of specific symptoms, and the procedure is not performed.
Common Pitfalls
- Billing A338 when the planned diagnostic radiology procedure is actually performed; in such cases, the procedure code should be billed, not A338.
- Using A338 for emergent evaluations where the procedure is not done; A335 is the correct code for emergent radiology consultations.
- Billing A338 when the procedure is cancelled or deferred due to procedural difficulties or lack of patient cooperation; A331 is the appropriate code in these specific circumstances.
Billing Tips
- Ensure the documentation clearly states the patient was evaluated to determine the advisability of a procedure that was subsequently not performed.
- Verify that no diagnostic radiology procedure code is billed for the same patient on the same date, as A338 is not payable in conjunction with a performed procedure.
Effective: June 1, 2025
Consultations and Visits
Diagnostic Radiology (33)
Consultations and Visits
Assessment
The radiologist must evaluate the patient to determine the advisability of a diagnostic radiological procedure.
The planned procedure must eventually not be performed.
The service must include a brief history and examination of the affected part/region or brief advice/information regarding health maintenance, diagnosis, treatment and/or prognosis.
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