A341 – Complex Medical Specific Re-Assessment
OHIP General Listings Code — Radiation Oncology (34) · Schedule of Benefits
A complex medical specific re-assessment is a re-assessment of a patient because of the complexity, obscurity, or seriousness of the patient’s condition. It requires a full, relevant history and physical examination of one or more systems.
When to Use
- Use A341 when reassessing a patient with a complex or serious oncological condition requiring a detailed history and physical examination of multiple systems, beyond what is covered by a standard A340.
- Bill A341 for a patient whose condition has become obscure due to treatment side effects or disease progression, necessitating a comprehensive re-evaluation.
- A341 is appropriate when a patient presents with a new, complex complication related to their cancer or its treatment, requiring a thorough assessment and management plan.
Common Pitfalls
- Submitting A341 without a written report to the primary care physician will result in the service being adjusted to a lesser assessment fee, likely A348.
- Billing A341 more than 4 times per patient per 12-month period (combined with A343) will lead to claim rejection for exceeding usage limits.
- Using A341 for a routine follow-up or a condition that is not complex, obscure, or serious may be considered inappropriate and subject to audit.
Billing Tips
- Ensure the chronic disease assessment premium (E078) is billed concurrently with A341 when the patient has an established chronic disease diagnosis, as this is common in oncology.
- Document the complexity, obscurity, or seriousness of the patient's condition and the rationale for the extensive history and physical examination in the patient's chart to support the A341 billing.
Effective: June 1, 2025
Consultations and Visits
Radiation Oncology (34)
Consultations and Visits
Assessment
Special Visit Premiums (Travel and First/Additional Person Seen) may be applicable if the service is rendered in an Emergency Department, Out-Patient Department, or as an In-patient visit during eligible times (evenings, nights, weekends, or holidays).
The fee for A341 is $83.40.
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