J165 – Transvaginal sonohysterography
OHIP Cardio-Thoracic Surgery Code — DIAGNOSTIC ULTRASOUND · Schedule of Benefits
Transvaginal sonohysterography is an ultrasound procedure that may include saline or other intracavitary contrast media, excluding Echovist used for demonstrating tubal patency. This service is divided into a technical component (H) and a professional component (P). Note that J138 and J161 rendered in conjunction with J165 are insured services but are payable at nil. For the procedural component involving the introduction of a catheter, refer to G399 in the Diagnostic and Therapeutic Procedures section.
When to Use
- Use J165 when performing a saline infusion sonohysterogram (SIS) to evaluate the uterine cavity for suspected polyps, fibroids, or synechiae.
- Use J165 specifically for the imaging component when contrast media is introduced to enhance visualization of the endometrium, distinguishing it from a standard pelvic ultrasound (J138 or J161).
Common Pitfalls
- Billing J138 or J161 alongside J165 will result in the former being paid at nil; always bill J165 as the primary diagnostic code for the procedure.
- Failing to bill G399 for the catheter insertion component results in lost revenue, as J165 only covers the professional/technical imaging component.
Billing Tips
- Always pair J165 with G399 on the same claim to capture both the procedural catheter insertion and the diagnostic imaging component.
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 the above upon request by the MOH.
The physician maintains documentation that describes the process by which the physician monitors quality assurance in accordance with professional standards.
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