All codes
X313
X313 – Level 4 - per patient, per course of treatment
OHIP Laboratory Code — RADIATION ONCOLOGY · Schedule of Benefits
Level 4 - Full 3D Treatment Preparation is a service payable per patient, per course of treatment. The radiation therapy must be oriented in two or more axes and must include one or more of the following treatments and corresponding NHPIP codes: - Full 3D target definition (volumetric imaging), 3D dose computation, 3D plan evaluation (NHPIP Code: 333) - Paediatric radiotherapy (NHPIP Code: 342) - Stereotactic radiotherapy - Total skin electron treatment - Total body irradiation - Intensity Modulated Radiotherapy (IMRT)
When to Use
- Use X313 when performing full 3D target definition and dose computation for IMRT or stereotactic radiotherapy plans.
- Apply this code for complex paediatric radiotherapy cases requiring specialized volumetric imaging and 3D planning.
- Use this code for total body irradiation or total skin electron treatment planning where 3D dose evaluation is required.
Common Pitfalls
- Billing X313 alongside X302, X304, X305, or X306 is a common error, as these codes are mutually exclusive for the same course of treatment.
- Submitting X313 without the corresponding NHPIP code (e.g., 333 or 342) will result in an automatic rejection.
- Attempting to bill X313 more than once per course of treatment is a frequent audit trigger, as it is strictly a per-course fee.
Billing Tips
- Ensure the NHPIP code is accurately linked to the X313 claim to validate the specific 3D planning complexity performed.
- Verify that the treatment plan involves orientation in two or more axes to meet the mandatory criteria for this level of service.
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