J107 – B-scan contact
OHIP Cardio-Thoracic Surgery Code — DIAGNOSTIC ULTRASOUND · Schedule of Benefits
J107 is a diagnostic ultrasound service for B-scan contact echography of the eye, typically used to evaluate the posterior structures of the eye when they cannot be directly visualized. This service is listed with a professional ('P') component and a technical ('H') component, which are billed separately using suffixes. - Professional Component: This fee is for the physician's service of interpreting the scan and providing a report. It must be rendered personally by the physician and is claimed using billing code `J107C`. - Technical Component ('H' fee): This fee covers the use of equipment, supplies, and personnel to perform the scan. As per , the technical component is not payable if rendered to a hospital in-patient or to an out-patient who is subsequently admitted within 24 hours for the same condition.
When to Use
- Use J107C when performing a B-scan to evaluate posterior segment pathology, such as vitreous hemorrhage or retinal detachment, where the fundus is obscured by opaque media.
- Use J107C for assessing the extent and location of intraocular foreign bodies or tumors when direct visualization is insufficient.
Common Pitfalls
- Billing the technical component (J107H) for hospital in-patients or out-patients who are subsequently admitted within 24 hours is a common audit trigger and will result in recovery.
- Failing to maintain a formal, signed interpretation report in the patient record will lead to a rejection of the professional component (J107C) during a post-payment audit.
Billing Tips
- Ensure the referral source is clearly documented in your records, as J107 requires a valid referral from a physician or authorized practitioner to be eligible for payment.
- If the patient is under 16, remember to apply the appropriate age-based premium to the professional component to maximize the claim value.
Effective: April 1, 2025
G. Diagnostic Ultrasound
DIAGNOSTIC ULTRASOUND
Diagnostic
Diagnostic Ultrasound
All insured services must be documented in appropriate records establishing that the service was provided, is the service submitted for payment, and was medically necessary.
The professional component requires a report of the findings, opinions, and recommendations.
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