J001 – Arthrogram, tenogram or bursogram
OHIP Cardio-Thoracic Surgery Code — CLINICAL PROCEDURES ASSOCIATED WITH DIAGNOSTIC RADIOLOGICAL EXAMINATIONS · Schedule of Benefits
J001 is the fee code for performing an arthrogram, tenogram, or bursogram. These procedures fall under the category of Clinical Procedures Associated with Diagnostic Radiological Examinations as listed in the OHIP Schedule of Benefits.
When to Use
- Use J001 when performing an arthrogram for diagnostic visualization of a joint space, such as the shoulder or hip, using contrast medium.
- Use J001 for a bursogram or tenogram procedure where contrast is injected into a bursa or tendon sheath for diagnostic imaging purposes.
Common Pitfalls
- Do not bill J001 for simple joint aspirations or injections; those are distinct procedures (e.g., G372) and do not include the diagnostic radiological component required for J001.
- Avoid billing J001 in conjunction with a consultation or assessment code on the same day unless the assessment is for a separate, unrelated clinical problem.
Billing Tips
- Ensure the procedure is performed as a non-elective service or an elective service delayed by an emergency to qualify for after-hours premiums like E409 or E410.
- Always document the specific joint or anatomical site and the use of contrast medium to support the claim for a diagnostic radiological procedure.
Effective: April 1, 2026
E. Clinical Procedures associated with Diagnostic Radiological Examinations
CLINICAL PROCEDURES ASSOCIATED WITH DIAGNOSTIC RADIOLOGICAL EXAMINATIONS
Procedure
Clinical Procedures associated with Diagnostic Radiological Examinations
When claiming the technical component of a diagnostic procedure, the physician must maintain documentation describing the quality assurance monitoring process. ()
All insured services must be documented in appropriate medical records establishing that the service was provided, is the service submitted for payment, and was medically necessary. ()
Biliary duct calculus manipulation etc. (see Z562 listed in Digestive System - Biliary Tract.)
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