E408 – After hours premium for urgent CT/MRI interpretation - Nights
OHIP Surgical Assists Code — OTHER PREMIUMS · Schedule of Benefits
Payable in addition to CT or MRI services for interpreting a study on an urgent basis via a picture archiving and communication system (PACS) during night hours (00:00h - 07:00h). The physician must be physically present in Ontario at a location other than the hospital where the patient receives the study. The interpretation must be provided via PACS using DICOM-compliant workstations and monitors, including a review of any relevant prior images available through the system.
When to Use
- Use E408 when you are off-site and provide an urgent teleradiology interpretation for an ED patient or hospital inpatient between 00:00 and 07:00.
- Use E408 when a study request is made during regular hours but technical or clinical delays force the interpretation to occur during the 00:00-07:00 window.
Common Pitfalls
- Billing E408 for interpretations performed while physically present at the hospital where the study was conducted, which is strictly prohibited.
- Failing to document the exact time of the request and the time of transmission, which leads to automatic rejection during Ministry audits.
- Claiming E408 for non-urgent studies or elective interpretations that do not meet the acute management criteria for ED or inpatient care.
Billing Tips
- Ensure your documentation explicitly justifies the urgency of the interpretation to satisfy the requirement for 'urgent management' of the patient.
- Always cross-reference your E408 claim with the primary CT or MRI technical fee code to ensure the link is established in your billing software.
Effective: April 1, 2025
GP. General Preamble
OTHER PREMIUMS
Premium
Other Premiums (including After Hours Procedure Premiums)
The time of the request and the time of the transmission of the interpretation must be recorded in the patient's permanent medical record.
A description of any factors referred to in the note regarding requests prior to the eligible after-hours period must be recorded in the patient's permanent medical record.
If the request for interpretation occurs prior to an eligible after hours period, but the interpretation cannot be provided prior to that eligible after hours period due to factors beyond the control of the interpreting physician, these premiums remain eligible for payment if the payment rules are otherwise satisfied.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.