1What Is the C353 OHIP Code?
What is C353?
C353 is an OHIP billing code specifically for urologists conducting detailed assessments of non-emergency hospital in-patients presenting with urological symptoms like retention, catheter issues, or haematuria. The process involves a full history and examination relevant to the presenting complaint to ensure precise diagnosis or to rule out disease.
This code is crucial for urologists who need to address acute in-patient concerns effectively, helping direct subsequent patient care methods. However, it is often missed due to tight consultation schedules or when documentation requirements aren’t fully met.
2Related Codes
| Code | Name | Frequency | Description |
|---|---|---|---|
| A353 | Specific assessment | 1 per patient per physician per 12 months if provided outside the hospital | Parallel to C353, for out-patient consultations. |
| C354 | Specific re-assessment | Varies as deemed by patient need and diagnostic change | For follow-up in-patient assessments after the initial specific assessment. |
| A354 | Partial assessment | Limited as per specific diagnosis and clinical management needs | For less comprehensive assessments performed outside hospital. |
| A935 | Special surgical consultation | As medically necessary for complex cases | Higher fee for more comprehensive and complex evaluations, specific to surgical need. |
3Eligibility Requirements
Eligibility Requirements for C353
To bill C353, the service must be rendered by a urology specialist in a hospital setting (non-emergency). Each patient is eligible for one specific assessment per physician per year. Exceptions allow for a second assessment if a different diagnosis is made or at least 90 days have passed and the patient is re-assessed during a hospital admission.
C353 can also be conducted virtually but only via video (C353A) and not by telephone. Proper documentation of service time (start and end) is mandatory in the patient's records. See General Preamble GP23 and GP7 for detailed instructions.
4What Your Clinical Note Must Show
Accurate time documentation is crucial for billing C353.
- Record exact time service started and ended.
- Include in patient's permanent medical record.
5Weak vs. Strong Note Examples
The strong note succeeds by providing a comprehensive patient history and specific examination details, aiding in justifying the billing. The weak note lacks this necessary detail.
Patient showed retention issues. Examined and advised.
Patient presented with urinary retention continued for 2 days, complex by current catheter malfunction. Detailed history taken; conducted physical examination focusing on bladder and catheter system.
- Reviewed recent catheter insertions and complications.
- Assessed functional status of urinary system.
