All codes
J036
J036 – Fistula or sinus injection
OHIP Cardio-Thoracic Surgery Code — CLINICAL PROCEDURES ASSOCIATED WITH DIAGNOSTIC RADIOLOGICAL EXAMINATIONS · Schedule of Benefits
Fistula or sinus injection is a clinical procedure associated with diagnostic radiological examinations. It involves injecting contrast material into a fistula or sinus to outline its path and any associated cavities, typically under imaging guidance.
When to Use
- Use J036 when performing a fistulogram or sinogram to delineate the tract of a chronic wound or sinus using contrast media under fluoroscopic or radiographic guidance.
- Use this code specifically for the injection procedure itself, distinct from the professional fee for the interpretation of the resulting diagnostic images.
Common Pitfalls
- Billing J036 in addition to an office assessment (A007/A001) is a common rejection, as the procedure is considered a constituent element of the visit unless specifically exempted.
- Attempting to bill J036 for simple wound irrigation or probing without the intent of diagnostic radiological imaging will lead to audit recovery.
Billing Tips
- Ensure you append the appropriate after-hours premium (E409, E410, E412, or E413) if the procedure meets the non-elective criteria, as J036 is explicitly eligible for these modifiers.
Provider Fee$29.40
Effective: April 1, 2026
Category
E. Clinical Procedures associated with Diagnostic Radiological Examinations
Subcategory
CLINICAL PROCEDURES ASSOCIATED WITH DIAGNOSTIC RADIOLOGICAL EXAMINATIONS
Service Type
Procedure
Code Classes
Clinical Procedures associated with Diagnostic Radiological Examinations
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