C344 – Medical specific re-assessment
OHIP Surgical Procedures Code — RADIATION ONCOLOGY (34) · Schedule of Benefits
A medical specific re-assessment (C344) is a service rendered by a specialist in Radiation Oncology in a non-emergency, acute care hospital in-patient setting. According to the Schedule of Benefits (see ), it requires a full, relevant history and physical examination of one or more systems. It is typically used for follow-up care for a previously assessed condition. An admission assessment may be billed as a C344 if the admitting physician has previously assessed the patient for the same presenting illness within the last 90 days (see ).
When to Use
- Use C344 for daily or periodic inpatient follow-up visits by a Radiation Oncologist for a patient previously assessed by you for the same illness within the last 90 days.
- Use C344 when performing an admission assessment for a patient you have already seen in your clinic for the same presenting condition within the 90-day window.
Common Pitfalls
- Billing C344 more than twice in a 12-month period will trigger an automatic payment adjustment to a lower assessment fee.
- Attempting to bill C344 alongside another assessment code for the same patient on the same day by the same physician will result in a rejection, as only one assessment is payable per visit.
- Using C344 for emergency department visits is incorrect; you must use the 'A' prefix codes (e.g., A340) for emergency or special visits to inpatients.
Billing Tips
- If the patient is in an ICU or CCU, remember to append the C101 premium to your C344 claim to capture the additional fee, provided no other team-based critical care fees are being claimed.
Effective: June 1, 2025
A. Consultations and Visits
RADIATION ONCOLOGY (34)
Assessment
Assessments, Hospital and Institutional Consultations and Assessments
Requires a full, relevant history and physical examination of one or more systems.
All insured services must be documented in the medical record to establish the service was provided, is the service submitted, and was medically necessary.
This service applies to non-emergency hospital in-patient services. See General Preamble to .
For emergency calls and other special visits to in-patients, use General Listings ('A' prefix codes) and Premiums when applicable (see General Preamble to ).
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