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T343

T343T343

OHIP Other Code · Schedule of Benefits

When to Use

  • Use T343 for the excision of a malignant lesion of the face, scalp, neck, genitalia, or hand where the lesion diameter is between 1.0 cm and 1.9 cm.
  • Select T343 instead of T342 when the lesion size exceeds 1.0 cm, as T342 is restricted to lesions less than 1.0 cm in these specific anatomical sites.

Common Pitfalls

  • Billing T343 for a benign lesion excision, which should instead be billed under the S-code series (e.g., S061 or S062) based on the specific anatomical site.
  • Attempting to claim T343 in conjunction with a minor procedure code like G372, which is considered bundled into the excision fee and will result in a rejection.

Billing Tips

  • Ensure the pathology report confirms malignancy, as the Ministry may request this documentation during an audit to justify the use of the T-series excision codes.
Provider Fee$131.70
Specialist Fee$131.70

Effective: February 1, 2011

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