J103 – B-scan immersion
OHIP Cardio-Thoracic Surgery Code — DIAGNOSTIC ULTRASOUND · Schedule of Benefits
J103 is for a B-scan immersion echography of the eye, a diagnostic ultrasound procedure used for imaging ocular structures. The fee is split into a professional component ('P' fee) and a technical component ('H' fee), which is payable for the use of equipment and personnel, typically in a hospital setting.
When to Use
- Use J103C for the professional interpretation of a B-scan immersion echography when the patient has an opaque media preventing standard fundus examination.
- Use J103B for the technical component when providing the equipment and personnel in a non-hospital clinic setting, provided the patient is not an inpatient.
Common Pitfalls
- Billing the technical component (J103B) for a patient who is an inpatient or who is admitted to the hospital within 24 hours of the service will result in an automatic rejection.
- Failing to append the correct suffix (C for professional, B for technical) will lead to claim rejection, as J103 is not a valid code on its own.
Billing Tips
- Always ensure the referring physician's written request is on file, as this is a mandatory requirement for diagnostic ultrasound services like J103.
Effective: April 1, 2025
G. Diagnostic Ultrasound
DIAGNOSTIC ULTRASOUND
Diagnostic
Diagnostic Ultrasound
The physician submitting a claim for the technical component is responsible for the complete quality assurance process for all elements of the technical component of the service, including data acquisition, reporting, and record keeping. The physician must be able to demonstrate this upon request by the MOH.
All insured services require documentation in the medical record to establish that the service was provided, was medically necessary, and matches the service claimed.
A copy of the written request for the service from the referring practitioner must be kept in the patient's record.
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