J045 – Percutaneous antegrade pyelogram
OHIP Cardio-Thoracic Surgery Code — CLINICAL PROCEDURES ASSOCIATED WITH DIAGNOSTIC RADIOLOGICAL EXAMINATIONS · Schedule of Benefits
Percutaneous antegrade pyelogram is a diagnostic imaging procedure to visualize the upper urinary tract (renal pelvis and ureter). It involves inserting a needle through the skin into the renal pelvis under imaging guidance and injecting contrast dye, followed by radiological imaging. This procedure is typically performed when other methods like retrograde pyelography are not feasible or have been unsuccessful. The fee is for one side.
When to Use
- Use J045 when performing a percutaneous antegrade pyelogram to visualize the upper urinary tract after a failed or impossible retrograde pyelogram.
- Use this code for diagnostic needle placement and contrast injection into the renal pelvis when imaging is required for clinical decision-making.
Common Pitfalls
- Billing J045 bilaterally is a common error; the fee is strictly for one side, and you must use the appropriate diagnostic code to justify the necessity if performing it on both kidneys.
- Confusing J045 with J046 (nephrostomy tube insertion) is a frequent audit risk; J045 is for the diagnostic imaging procedure only, not the therapeutic placement of a drainage catheter.
Billing Tips
- Ensure the procedure note clearly documents the radiological guidance used, as this is a clinical requirement for the J-code series.
- If an anaesthesiologist is required, remember that J045 carries 6 basic units for anaesthesia billing purposes.
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
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