J193 – Peripheral vessel assessment - doppler scan or B scan
OHIP Cardio-Thoracic Surgery Code — DIAGNOSTIC ULTRASOUND · Schedule of Benefits
Peripheral vessel assessment involving a doppler scan or B scan of an artery and/or vein in one extremity (unilateral), distal to the inguinal ligament or axilla. The fee includes frequency/spectral analysis, if rendered. This service is mutually exclusive with J202 on the same extremity per day and should not be billed routinely with J190.
When to Use
- Use J193 for a unilateral diagnostic ultrasound assessment of a peripheral artery or vein in a single extremity, such as evaluating for DVT or arterial insufficiency.
- Select J193 when performing a targeted Doppler or B-scan assessment of a specific vessel segment distal to the inguinal ligament or axilla.
Common Pitfalls
- Billing J193 alongside J202 for the same extremity on the same day will result in an automatic rejection due to mutual exclusivity.
- Routine billing of J193 in conjunction with J190 is flagged by the Ministry as an audit risk, as these services are intended for distinct diagnostic purposes.
Billing Tips
- Ensure the claim clearly specifies the extremity (left or right) to avoid payment delays, as J193 is strictly defined as a unilateral service.
Effective: April 1, 2025
G. Diagnostic Ultrasound
DIAGNOSTIC ULTRASOUND
Diagnostic
Diagnostic Ultrasound, Diagnostic and Therapeutic Procedures
For the technical component, the physician must have the necessary training and experience to personally render the service and maintain documentation that describes the process by which the physician monitors quality assurance in accordance with professional standards.
All insured services must be documented in appropriate records, establishing that the service was provided, medically necessary, and matches the service for which the account is submitted.
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