What is OHIP billing code J167?

J167 is "Fetal Doppler evaluation of middle cerebral artery and/or ductus venosus", an OHIP Cardio-Thoracic Surgery code from the Ontario Schedule of Benefits (Physician Services).

How much does J167 pay?

The current OHIP fee for J167 is $0.00, effective 2025-04-01, per the Ontario Schedule of Benefits.

How do I bill J167 to OHIP?

J167 is submitted through OHIP's MCEDT claims system, either directly or via billing software. SnapBill validates J167 claims against the Schedule of Benefits rules before submission.

What codes are related to J167?

Codes related to J167 in the Schedule of Benefits include J160, J158.

All codes

J167

J167 – Fetal Doppler evaluation of middle cerebral artery and/or ductus venosus

OHIP Cardio-Thoracic Surgery Code — DIAGNOSTIC ULTRASOUND · Schedule of Benefits

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A fetal Doppler evaluation of the middle cerebral artery and/or ductus venosus, payable only as an add-on to J160 or J158. This diagnostic ultrasound service consists of a technical component (H-fee) and a professional component (P-fee). Payment is contingent on the patient meeting specific criteria for fetal anemia, intrauterine growth retardation, or being part of a high-risk pregnancy, as detailed in the payment rules on page .

When to Use

Use J167 when performing MCA-PSV measurements to screen for fetal anemia in cases of suspected alloimmunization or parvovirus B19 infection.
Use J167 to assess ductus venosus flow patterns in cases of severe intrauterine growth restriction (IUGR) where fetal compromise is suspected.
Use J167 as an add-on to J158 or J160 when monitoring high-risk pregnancies that meet the specific percentile growth criteria defined in the Schedule of Benefits.

Common Pitfalls

Billing J167 as a standalone service will result in automatic rejection; it must be submitted on the same claim as J158 or J160.
Failure to bill both the H-fee (technical) and P-fee (professional) components separately will result in underpayment, as the code is split into these two distinct components.
Submitting J167 without documented evidence of IUGR (e.g., EFW or AC <10th percentile) or high-risk status risks audit recovery.

Billing Tips

Ensure the ultrasound report explicitly documents the MCA or ductus venosus waveforms to support the medical necessity of the add-on code.
Verify that the primary scan (J158 or J160) is billed for the same date of service to ensure the J167 add-on is processed correctly.

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Provider Fee$0.00

Surgical Assistant Fee$33.90

Anaesthetist Fee$30.00

Non-Anaesthetist Fee$30.00

Effective: April 1, 2025

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