J043 – Bronchogram - bilateral
OHIP Cardio-Thoracic Surgery Code — CLINICAL PROCEDURES ASSOCIATED WITH DIAGNOSTIC RADIOLOGICAL EXAMINATIONS · Schedule of Benefits
Bilateral bronchogram is a diagnostic imaging procedure that uses a contrast agent to visualize both sides of the bronchial tree. This service is listed under Clinical Procedures Associated with Diagnostic Radiological Examinations. See also J002 for unilateral bronchogram and J003/J042 for bronchogram with intra-tracheal catheter.
When to Use
- Use J043 when performing a diagnostic bronchogram specifically involving both sides of the bronchial tree.
- Select J043 instead of J002 when the procedure is bilateral, as J002 is strictly for unilateral bronchograms.
Common Pitfalls
- Billing J043 in conjunction with J002 is a common error; the bilateral code J043 is intended to cover the entire procedure.
- Failure to include a valid referral from a physician or nurse practitioner will result in an automatic rejection of the claim.
Billing Tips
- Ensure the procedure documentation explicitly confirms bilateral involvement to support the use of J043 over the unilateral J002 code.
- If the procedure is performed as a non-elective service in a hospital setting, verify eligibility for applicable Special Visit Premiums (e.g., C109, C110) to maximize the claim value.
Effective: April 1, 2025
E. Clinical Procedures associated with Diagnostic Radiological Examinations
CLINICAL PROCEDURES ASSOCIATED WITH DIAGNOSTIC RADIOLOGICAL EXAMINATIONS
Procedure
Clinical Procedures associated with Diagnostic Radiological Examinations
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