1What Is the A335 OHIP Code?
The A335 code under OHIP caters to specific radiology consultations which involve a written opinion on radiographs or ultrasounds made at a different institution. This service may be called upon in several scenarios, including when a radiologist must provide consultation remotely before an interventional procedure, or if a unique visit is required during off-hours to assist with determining the advisability of a potential radiological procedure.
Despite its seemingly narrow criteria, such consultations are vital in ensuring that patients undergo appropriate and necessary diagnostic exams. However, it is crucial to be aware that the A335 code does not cover consultations regarding second opinions on CT or MRI scans. Physicians often overlook this code due to misconceived associations with standard interventional procedures.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A365 | Special interventional radiological consultation | Used for more complex radiological consultations, typically involving specialized interventional procedures. | |
| C335 | Consultation | The equivalent consultation code used for services rendered to hospital in-patients. | |
| C365 | Special interventional radiological consultation | Similar to A365 but used within a hospital in-patient context. | |
| A331 | Minor assessment | Used for less comprehensive assessments in diagnostic radiology. |
3Eligibility Requirements
A335 is applicable when:
- Radiographs or ultrasounds made at one facility are referred for a written opinion at another.
- A radiologist is specially called in during off-hours to assess if a radiological procedure should proceed, and the procedure is subsequently not performed.
- An opinion is required before an interventional procedure away from the usual procedural area of the radiologist.
It is important to note that services involving comparisons with radiographs made at the consultant's facility or for CT/MRI second opinions are not eligible under A335. Furthermore, the service can be billed virtually via video under A335A, which should be appropriately documented.
4What Your Clinical Note Must Show
To ensure payment, the following documentation should be meticulously recorded:
- A written request for the consultation from a referring physician, nurse practitioner, or dental surgeon.
- A written report by the consulting radiologist detailing findings, opinions, and recommendations.
- The time (to the minute) when the service started and ended.
- Identification details of the consultant, referring professional, and patient, along with relevant billing numbers.
5Weak vs. Strong Note Examples
The strong note is successful due to its detailed documentation of the consultation process and timing, providing clarity and meeting OHIP's documentation requirements, whereas the weak note lacks these critical aspects and fails to justify the billed service.
Consultation on chest x-rays performed. Discussed findings with Dr. Smith. Advised CT scan but no action documented. Time not recorded.
Consultation requested by Dr. Smith for review of chest x-rays taken at General Hospital. Provided written opinion suggesting potential diagnostic pathways. Recommended deferring CT scan for clinical reevaluation. Date and time documented from 15:00 to 15:45.
- Clear identification of the referring and consulting professionals.
- Comprehensive written report prepared with detailed recommendations.
- Documented time specifics ensuring service duration is clear.
