1What Is the A356 OHIP Code?
What is A356?
A356 is the OHIP billing code designated for repeat consultations in the specialty of Urology. This service is performed when a urologist reevaluates a patient for the same issue upon a new referral, after the patient has received care from another healthcare provider. Typical scenarios include patients initially managed conservatively for conditions like obstructive symptoms or small renal lesions, who are referred back due to a change in their clinical status.
Because A356 is a repeat consultation, it is required that the consulting physician receives a new written request from the referring physician, nurse practitioner, or dental surgeon. The recorded encounter helps ensure continuity of care and appropriate evaluation as clinical circumstances evolve.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A935 | Special surgical consultation | Not limited by the standard frequency except special conditions apply | More extensive surgical evaluation, usually involving broader concerns or complex cases. |
| C935 | Special surgical consultation | In-hospital equivalent of A935 | Equivalent to A935 when performed for hospital in-patients. |
| A355 | Consultation | Limited by standard consultation frequency | Initial consultation for urological concerns. |
| C355 | Consultation | In-hospital equivalent of A355 | Equivalent to A355 when carried out in a hospital setting. |
3Eligibility Requirements
Eligibility Requirements
According to the OHIP Schedule of Benefits, the following criteria must be met for billing A356:
- A new written request for the consultation, signed by the referring physician, nurse practitioner, or dental surgeon, must be maintained in the consulting urologist’s medical records.
- This service may be conducted via video, billed as A356A, under the eligible Comprehensive Virtual Care Services clause, as long as no telephone-only consultations are billed.
- Repeat consultations are not constrained by the General Preamble GP17's consultation frequency limits, provided each instance has documented justification as per GP19.
These criteria serve to validate the various stages of care and facilitate the transition between healthcare providers.
4What Your Clinical Note Must Show
To ensure compliance and successful billing for A356, the following documentation needs to be in place:
- A copy of the new written consultation request must be stored in the patient's medical record.
- A documented assessment consistent with repeat consultation requirements, reflecting the continuity of care.
5Weak vs. Strong Note Examples
The strong note succeeds by explicitly documenting the new referral source, context from the initial condition, and the rationale for the reassessment, ensuring clarity and completeness.
Patient seen again for issue noted before. Referral received. Reviewed status.
Patient presented for a repeat consultation on a prior noted renal lesion, initially managed conservatively as per Dr. Smith's referral dated [date]. Following interim evaluation by Dr. Brown where changes were noted, patient is re-referred for reassessment.
Assessment today includes a comprehensive review of new imaging studies and discussion of possible intervention strategies.
- New written referral from Dr. Brown received.
- Further diagnostic recommendations made considering updated symptoms.
