A365 – Special Interventional Radiological Consultation
OHIP General Listings Code — Diagnostic Radiology (33) · Schedule of Benefits
A special interventional radiological consultation is the service described under part (c) of a regular consultation (A335) in circumstances in which because of the very complex, obscure or serious nature of the problem, the physician is required to spend a minimum of 50 minutes in direct contact with the patient exclusive of time spent rendering any other separately billable intervention to the patient.
When to Use
- When a patient requires a detailed, 50+ minute discussion regarding a complex interventional radiology case, such as evaluating multiple failed angioplasties or a complex tumor ablation plan, and no intervention is performed during this specific encounter.
- If a patient presents with a rare vascular malformation requiring extensive discussion of treatment options, and the radiologist spends over 50 minutes in direct consultation, separate from any procedural time.
- When a patient needs a thorough assessment and discussion of a complicated biliary obstruction requiring multiple potential interventional approaches, and the consultation itself meets the 50-minute minimum requirement.
Common Pitfalls
- Billing A365 when the 50-minute direct patient contact requirement is not met; this often leads to claims being downgraded to a standard consultation (A335) or denied.
- Including time spent reviewing imaging or dictating reports in the 50-minute patient contact time, as only direct patient interaction is billable for A365.
- Billing A365 for consultations that are primarily for obtaining consent or clarifying procedural details, as these are explicitly excluded.
Billing Tips
- Ensure the consultation occurs in a location remote from the radiologist's usual procedural suite, such as a dedicated consultation room or the patient's ward, to meet the service requirements.
- Verify that the consultation is directly related to one of the specified interventional procedures (e.g., J021, J040, N107) and that a written report is sent to the referring provider.
Effective: June 1, 2025
Consultations and Visits
Diagnostic Radiology (33)
Diagnostic Radiology
Consultation
A written report (including findings, opinions, and recommendations) must be sent to the referring physician, nurse practitioner or dental surgeon.
A copy of the written request for the consultation, signed by the referring physician, nurse practitioner or dental surgeon must be kept in the consulting physician’s medical record (unless common medical records are maintained in a hospital, long-term care institution or multi-specialty clinic).
The written request must identify the consultant by name and/or specialty, the referring physician, nurse practitioner or dental surgeon by name and billing number, and the patient by name and health number.
The written request must set out information relevant to the referral and specify the service(s) required.
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