X311 – Level 2 - Intermediate Treatment Planning
OHIP Laboratory Code — RADIATION ONCOLOGY · Schedule of Benefits
Level 2 - Intermediate Treatment Planning is payable per patient, per course of treatment. This service must include one or more of the following treatments and corresponding National Hospital Productivity Improvement Project (NHPIP) codes as published in 'Activity-Based Funding for Radiation Services in Ontario, “Refining the Task Force on Human Resources for Radiation Services’ Interim Funding Formula, April 2001” Joint Policy and Planning Committee (JPPC) Report by the sub-committee Radiation Funding Working Group (RFWG)': - Any 2, 3 or 4 field cases with contour (NHPIP Codes: 103, 104, 110, 111, 170, 215, 381, 382) - Any case with contrast media/insertion (NHPIP Codes: 150, 151, 152, 160, 161, 191) - Any 2, 3 or 4 field cases with 2D computerized dose distribution (NHPIP Codes: 310, 311, 312) - Any extended SSD cases (NHPIP Code: 120) - All cases with standard shielding (NHPIP Codes: 220, 230) - All cases with simple wax/Pb cut-out (NHPIP Codes: 240, 259) This service is for planning that is more complex than a Level 1 plan (X310) but does not meet the criteria for Level 3 (X312) or Level 4 (X313) planning.
When to Use
- Use X311 for 2, 3, or 4 field radiation plans that require manual contouring or 2D computerized dose distribution, which exceeds the basic scope of X310.
- Apply this code for treatments involving standard shielding or simple wax/Pb cut-outs that do not meet the complexity threshold for X312.
- Select X311 when contrast media or specific insertions are utilized during the planning process, provided the case does not qualify for higher-level planning codes.
Common Pitfalls
- Billing X311 for cases that only meet X310 criteria will result in audit recovery; ensure the specific NHPIP code requirement is documented.
- Attempting to bill X311 alongside X312 or X313 for the same course of treatment is a common rejection error, as planning codes are generally mutually exclusive per course.
- Failure to link the specific NHPIP code (e.g., 220 or 240) in the clinical record can lead to claim reversal during a Ministry review.
Billing Tips
- Always cross-reference your planning documentation with the specific NHPIP codes listed in the JPPC report to ensure the selected level (X311) is defensible against the criteria for X310 or X312.
Effective: April 1, 2025
C. Radiation Oncology
RADIATION ONCOLOGY
Procedure
Radiation Oncology
Treatment levels are defined by National Hospital Productivity Improvement Project (NHPIP) Codes as published in Activity-Based Funding for Radiation Services in Ontario, “Refining the Task Force on Human Resources for Radiation Services' Interim Funding Formula, April 2001" Joint Policy and Planning Committee (JPPC) Report by the sub-committee Radiation Funding Working Group (RFWG).
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