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E448 – Signs or symptoms - with 3D tomosynthesis

OHIP Diagnostic Radiology Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits

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An add-on premium for 3D tomosynthesis when performed in conjunction with a mammogram (unilateral or bilateral, with or without signs/symptoms).
Must be performed using 3D tomosynthesis modality.
X172Mammogram - unilateral (No signs or symptoms)X178Mammogram - bilateral (No signs or symptoms)X184Mammogram - unilateral (Signs or symptoms)X185Mammogram - bilateral (Signs or symptoms)X169Laminogram, planigram, tomogramX417Three dimensional CT acquisition sequencing, including post-processing

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