A340 – Medical Specific Re-Assessment
OHIP General Listings Code — Radiation Oncology (34) · Schedule of Benefits
A medical specific re-assessment is a service rendered by a specialist in Radiation Oncology that requires a full, relevant history and physical examination of one or more systems.
When to Use
- Bill A340 when a Radiation Oncology specialist performs a comprehensive history and physical examination for a patient in their office or an outpatient clinic, and the patient is not an inpatient.
- Use A340 for a follow-up assessment of a patient's radiation oncology condition that requires a new, detailed history and physical, distinct from a simple follow-up visit (e.g., A348 Partial Assessment) or a repeat consultation (A346).
- A340 is appropriate when a specialist assesses a patient for a new radiation oncology issue or a significant change in an existing one, necessitating a full review of relevant systems.
Common Pitfalls
- Billing A340 for a patient already admitted to hospital; use C344 (Medical Specific Re-assessment - In-patient) instead.
- Exceeding the limit of two A340s per patient per physician per 12 months without meeting the exemption criteria for hospital admissions; this can lead to payment adjustment to a lesser assessment fee like A348.
- Billing A340 on the same day as another assessment or consultation by the same physician, unless specific exceptions apply, as it is generally not payable.
Billing Tips
- For virtual care, remember to append the 'A' suffix to the code, making it A340A.
- A340 is eligible for the E078 Chronic Disease Assessment Premium if the patient has a documented chronic disease, the service is rendered in an office or outpatient hospital clinic setting, and the patient is not an inpatient or in long-term care.
Effective: June 1, 2025
Consultations and Visits
Radiation Oncology (34)
Consultations and Visits
Assessment
Requires a full, relevant history and physical examination of one or more systems.
Admission assessments are deemed to be a medical specific re-assessment if the physician assessed the patient prior to admission in respect of the same illness.
Specific re-assessments rendered for hospital admissions are exempt from the limit of two per 12 months.
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