J010 – Lymphangiogram - per side
OHIP Cardio-Thoracic Surgery Code — CLINICAL PROCEDURES ASSOCIATED WITH DIAGNOSTIC RADIOLOGICAL EXAMINATIONS · Schedule of Benefits
Lymphangiogram, performed per side. This is a clinical procedure associated with diagnostic radiological examinations. As per the and , this service includes all common elements of insured services such as obtaining history, maintaining records, and providing the necessary premises and equipment.
When to Use
- Use J010 when performing a diagnostic lymphangiogram procedure on one side of the body.
- Use J010 in conjunction with radiological imaging where the clinical procedure of cannulation and contrast administration is required.
- Use J010 specifically for the procedural component, ensuring it is distinct from the professional interpretation fee of the associated radiological study.
Common Pitfalls
- Billing J010 bilaterally without specifying the quantity or site, which may lead to payment for only one side.
- Failing to document the medical necessity of the procedure in the patient record, which is a requirement under GP8.
- Attempting to claim J010 alongside other procedural codes that include the same clinical elements, potentially triggering a duplicate service rejection.
Billing Tips
- If performing the procedure on both sides, bill J010 with a quantity of 2 to ensure the full fee is captured for both sides.
- Always ensure the referring physician or nurse practitioner information is included on the claim, as a referral is mandatory for this diagnostic 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 E420 trauma premium, the medical record must list the Injury Severity Score (ISS).
As per , all insured services must be documented in appropriate records to establish that: 1. an insured service was provided; 2. the service for which the account is submitted is the service that was rendered; and 3. the service was medically necessary.
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