< Billing codes

Billing code

A353A — Urology specific assessment

Urology specific assessment

A urologist bills A353 for a full history of the complaint and detailed exam of the affected parts or systems, outside the patient's home.

Watch for: One per patient per physician per 12 months, two only for an unrelated diagnosis; extras pay a lesser fee.

Code

A353A

Description

Urology specific assessment

FHO+ basket

Not in the FHO+ base rate basket (Schedule 2 or 2B).

Effective date

Apr 1, 2026

Termination date

No end date

Explanation

Updated October 26, 2026

Specific assessment by a urologist: full history of the complaint and detailed exam of the affected parts or systems.

What it covers

A specific assessment is rendered by a specialist outside the patient's home and needs a full history of the presenting complaint and a detailed exam of the affected part(s), region(s) or system(s) (GP23).

Starred (*) urology consults and assessments may include a genito-urinary exam and, when needed, urethral calibration, catheterization and prostatic fluid examination, but not endoscopy (A207).

Billing rules

• Limited to one per patient per physician per 12 months; two if a clearly different, unrelated diagnosis is made (GP23).
• Over the limit, it's paid at a lesser fee (GP23).
• Detention (K001) may start after 60 minutes (GP30).
• Can be done by video or telephone with an existing relationship; add K300A or K301A (Appendix J, A66).

Common rejections

• AT3: Billed as virtual care (K300A/K301A) and OHIP found no existing patient-physician relationship, such as an in-person service with you in the past 24 months (A66).

Related codes: A354, A355, A356, C353, C354

Source: Schedule of Benefits (July 1, 2026), Consultations and Visits, Urology (35), page A206.

APEX checks every paid claim against the Schedule of Benefits and flags codes billed below what the visit qualified for. See how APEX works · Pricing