J135 – Abdominal scan - complete
OHIP Cardio-Thoracic Surgery Code — DIAGNOSTIC ULTRASOUND · Schedule of Benefits
A complete diagnostic ultrasound scan of the abdomen and retroperitoneum. The fee for this service is divided into a technical component (H) and a professional component (P). For a more limited study, see J128.
When to Use
- Use J135 when a comprehensive survey of the upper abdomen is required, including the liver, gallbladder, biliary tree, pancreas, spleen, and kidneys.
- Select J135 for patients requiring a full retroperitoneal evaluation, such as assessing the abdominal aorta or para-aortic lymph nodes, which exceeds the scope of a limited J128 scan.
Common Pitfalls
- Billing J135 for a limited or organ-specific scan is a common audit trigger; use J128 if the clinical indication only requires assessment of a single organ.
- Attempting to bill J135 alongside other abdominal ultrasound codes for the same patient on the same day will result in automatic rejection due to the comprehensive nature of the code.
Billing Tips
- Ensure the diagnostic report explicitly lists the findings for all required abdominal organs to justify the 'complete' status of the J135 claim.
Effective: April 1, 2025
G. Diagnostic Ultrasound
DIAGNOSTIC ULTRASOUND
Diagnostic
Diagnostic Ultrasound
The Act requires that the medical record establish that: an insured service was provided; the service for which the account is submitted is the service that was rendered; and the service was medically necessary.
Heart - Echocardiography - see listings in Diagnostic and Therapeutic Procedures.
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