J020 – Myelogram - with posterior fossa views
OHIP Cardio-Thoracic Surgery Code — CLINICAL PROCEDURES ASSOCIATED WITH DIAGNOSTIC RADIOLOGICAL EXAMINATIONS · Schedule of Benefits
This is an add-on fee for a myelogram procedure (J011) that specifically includes views of the posterior fossa. It is intended to be claimed in addition to the fee for the primary myelogram service.
When to Use
- Use J020 only when posterior fossa views are specifically performed and documented during a myelogram procedure billed under J011.
- Claim this code when the clinical indication requires visualization of the posterior fossa, such as suspected foramen magnum pathology or cerebellar tonsillar herniation, in addition to the standard spinal myelogram.
Common Pitfalls
- Billing J020 as a standalone procedure; it is strictly an add-on code and will be rejected if not submitted on the same claim as J011.
- Failing to document the specific requirement for posterior fossa views, which may lead to recovery during an audit if the necessity of the additional views is not clear.
Billing Tips
- Ensure the J011 and J020 codes are linked on the same claim to trigger the correct processing of the add-on fee.
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
This is an add-on fee to be claimed in conjunction with J011 (Myelogram) when posterior fossa views are performed.
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