E874 – CT perfusion study
OHIP Surgical Assists Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
This service is an add-on premium payable in addition to a qualifying head CT scan when a CT perfusion study is rendered. It is only eligible for payment for the investigation of acute stroke where the interpretation is provided within the limited period of time following acute stroke during which the treating physician must render therapeutic decisions. The fee for E874 includes: - The administration of contrast necessary to complete the CT perfusion study. - Creation and interpretation of post-imaging colour mapping of cerebral perfusion maps for regional cerebral blood flow, cerebral blood volume, and mean blood transit time.
When to Use
- Use E874 as an add-on to a non-contrast head CT (e.g., X400 or X402) when performing a perfusion study for acute stroke triage.
- Use E874 specifically when the clinical context requires immediate cerebral perfusion mapping to inform time-sensitive therapeutic decisions like thrombolysis or thrombectomy.
Common Pitfalls
- Billing E874 in combination with a contrast-enhanced CT head (e.g., X401 or X405) is a billing error; the code is strictly intended to supplement non-contrast imaging.
- Submitting E874 for elective or non-acute stroke imaging will result in rejection, as the code requires the interpretation to occur within the immediate therapeutic window for acute stroke.
- Failing to include the base non-contrast CT code (X400/X402) on the same claim will lead to rejection, as E874 is an add-on premium, not a standalone service.
Billing Tips
- Ensure your documentation explicitly notes the time-sensitive nature of the stroke investigation to support the 'acute' requirement of the code.
- Apply the appropriate age-based premium (e.g., AGE_PREMIUM_LT_16Y) to E874 if the patient meets the specific age criteria to maximize the claim value.
Effective: April 1, 2025
D. Diagnostic Radiology
DIAGNOSTIC RADIOLOGY
Diagnostic
Diagnostic Radiology
1. **E874** is only eligible for payment when the study is rendered as part of the investigation of acute stroke and the interpretation is rendered within the limited period of time following acute stroke during which the treating physician must render therapeutic decisions. 2. **E874** includes the administration of contrast necessary to complete the CT perfusion study. 3. **E874** includes creation and interpretation of post-imaging colour mapping of cerebral perfusion maps for regional cerebral blood flow, cerebral blood volume, and mean blood transit time.
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