J064 – Exchange or replacement of drainage tube
OHIP Cardio-Thoracic Surgery Code — CLINICAL PROCEDURES ASSOCIATED WITH DIAGNOSTIC RADIOLOGICAL EXAMINATIONS · Schedule of Benefits
A clinical procedure for the exchange of drainage tubes. The service includes supervision, imaging, and any hard copy film interpretation. As with all insured services, this procedure includes the common elements outlined in the Schedule of Benefits, such as making appointments, obtaining patient history, maintaining records, and conferring with other professionals as needed. See pages - for a full list of common elements.
When to Use
- Use J064 for the routine exchange or replacement of an existing percutaneous drainage tube, such as a nephrostomy or biliary drain, where imaging guidance is utilized.
- Use J064 when a patient presents for a scheduled tube change to maintain patency, distinct from the initial insertion procedure.
Common Pitfalls
- Do not bill J064 in addition to diagnostic imaging fees for the same encounter, as the code explicitly includes supervision, imaging, and interpretation.
- Avoid billing J064 for simple dressing changes or external tube maintenance that does not involve the exchange or replacement of the internal drainage device.
- Failure to link the appropriate assessment code (A-prefix) when claiming a Special Visit Premium alongside J064 will result in automatic rejection.
Billing Tips
- Ensure the procedure is claimed with the appropriate after-hours premium (E409/E410) if the non-elective exchange occurs outside standard business hours, provided you are not an Emergency Department physician.
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, Diagnostic and Therapeutic Procedures
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