All codes
A353
A353 – Specific Assessment
OHIP General Listings Code — Urology (35) · Schedule of Benefits
A specific assessment rendered by a specialist in Urology, requiring a full history of the presenting complaint and a detailed examination of the affected part(s), region(s), or system(s) needed to make a diagnosis, exclude disease, and/or assess function.
When to Use
- Bill A353 for a new patient presenting with persistent urinary incontinence requiring a detailed history and physical examination of the genitourinary system to establish a diagnosis.
- Use A353 when a urologist performs a comprehensive assessment for a patient with newly diagnosed erectile dysfunction, including history, physical exam, and discussion of treatment options.
- A353 is appropriate for a patient referred for evaluation of hematuria, necessitating a thorough history and focused physical examination to determine the cause.
Common Pitfalls
- Billing A353 for a patient already seen for the same complaint within 12 months without a documented, unrelated new diagnosis will result in adjustment to A354.
- Submitting A353 for an inpatient consult; use C353 instead for non-emergency hospital in-patient services.
- Attempting to bill separately for bundled services like catheterization or urethral calibration when performed during the A353 assessment, as these are included in the fee.
Billing Tips
- Ensure the documentation clearly supports a 'full history of the presenting complaint' and a 'detailed examination of the affected part(s), region(s), or system(s)' to justify the A353 code.
- A353 is eligible for Special Visit Premiums (e.g., C801, C802) if the visit is non-elective and meets the criteria outlined in GP65-GP78.
Provider Fee$0.00
Specialist Fee$46.80
Effective: June 1, 2025
Category
Consultations and Visits
Subcategory
Urology (35)
Service Type
Consultations and Visits
Code Classes
Assessment
Does not include endoscopic examination.
Eligible for Special Visit Premiums (Travel and First/Additional Person) if the visit is non-elective and meets the criteria in -.
Not eligible for age-based percentage premiums ().
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.