All codes
A343
A343 – Medical Specific Assessment
OHIP General Listings Code — Radiation Oncology (34) · Schedule of Benefits
Medical Specific Assessment - Radiation Oncology
When to Use
- Bill A343 for the initial consultation and assessment of a new patient presenting with a suspected or confirmed malignancy requiring radiation oncology planning.
- Use A343 when a patient is referred for a second opinion regarding radiation therapy options, involving a comprehensive review of their case and a detailed discussion of treatment.
- A343 is appropriate for a patient with a newly diagnosed cancer who requires a thorough assessment, including history, physical exam, review of imaging and pathology, and discussion of treatment modalities.
Common Pitfalls
- Billing A343 for a follow-up visit that is primarily for treatment delivery or routine monitoring; these may be billable under A340 or A341 if re-assessment is required.
- Using A343 when a simpler assessment code like A348 (Partial Assessment) would suffice, potentially leading to audit scrutiny if the complexity doesn't warrant a full assessment.
- Failing to document the comprehensive nature of the assessment, including history, physical exam, and discussion of findings and plan, which is required for A343.
Billing Tips
- Ensure the patient has an established diagnosis of a chronic disease to bill the E078 Chronic Disease Assessment Premium in conjunction with A343, provided all other criteria are met.
- A343 includes arrangements for related assessments and therapy; do not bill separately for these components if they are part of the initial consultation and planning process.
Provider Fee$0.00
Specialist Fee$80.40
Effective: June 1, 2025
Category
Consultations and Visits
Subcategory
Radiation Oncology (34)
Service Type
Consultations and Visits
Code Classes
Assessment
Physician in hospital but not on duty in the Emergency Department when seeing patient(s) in the Emergency or OPD - use General Listings.
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