J007 – Tomogram
OHIP Cardio-Thoracic Surgery Code — CLINICAL PROCEDURES ASSOCIATED WITH DIAGNOSTIC RADIOLOGICAL EXAMINATIONS · Schedule of Benefits
J007 is the code for a tomogram, a diagnostic procedure listed in the Miscellaneous Procedures subsection of the Clinical Procedures Associated with Diagnostic Radiological Examinations section of the Schedule. The fee is not specified and is subject to Independent Consideration (IC) by a medical consultant. Anaesthesia services are eligible for payment with 7 basic units plus time units. Assistant at surgery services are also applicable.
When to Use
- Use J007 for complex diagnostic tomographic procedures that lack a specific fee code in the Schedule of Benefits.
- Use this code when performing specialized diagnostic imaging procedures that require Independent Consideration (IC) due to the unique nature or complexity of the examination.
Common Pitfalls
- Submitting the claim without a detailed letter of explanation and supporting operative or consultation reports will result in an automatic rejection for IC services.
- Failing to provide a comparative analysis of the procedure's scope and difficulty against non-IC codes often leads to significant delays or denials by the medical consultant.
Billing Tips
- Ensure your submission explicitly justifies the fee amount by benchmarking the procedure's complexity against established, non-IC diagnostic codes found in the Schedule.
Effective: April 1, 2025
E. Clinical Procedures associated with Diagnostic Radiological Examinations
CLINICAL PROCEDURES ASSOCIATED WITH DIAGNOSTIC RADIOLOGICAL EXAMINATIONS
Diagnostic
Clinical Procedures associated with Diagnostic Radiological Examinations
As an Independent Consideration (IC) service, claims must be submitted with a supporting letter explaining the amount of the fee claimed, and must include an appropriate operative or consultation report, and a comparison of the scope and difficulty of the procedure in relation to non-IC procedures in the Schedule.
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