All codes
J196
J196 – Ankle pressure measurements with exercise and/or quantitative measurements
OHIP Cardio-Thoracic Surgery Code — DIAGNOSTIC ULTRASOUND · Schedule of Benefits
An add-on to J200 for ankle pressure measurements with exercise and/or quantitative measurements. The Schedule lists a technical component (H) fee of $8.00 and a professional component (P) fee of $10.10 for this service.
When to Use
- Use J196 as an add-on to J200 when performing post-exercise ankle-brachial index (ABI) measurements to assess for intermittent claudication.
- Apply this code when utilizing quantitative plethysmography or automated segmental pressure measurements that require a hard-copy printout as part of a vascular assessment.
Common Pitfalls
- Billing J196 in conjunction with G517 will result in a rejection, as G517 is specifically restricted when J200/J196 services are rendered.
- Submitting J196 without a corresponding J200 claim will trigger a rejection because J196 is strictly an add-on code.
- Failure to maintain a hard-copy output from the diagnostic device is a common audit failure point that leads to full recovery of the professional fee.
Billing Tips
- Ensure your diagnostic equipment is configured to generate a physical or digital hard-copy report, as this is a mandatory requirement for the professional component (P) fee.
Provider Fee$0.00
Surgical Assistant Fee$8.45
Anaesthetist Fee$10.10
Non-Anaesthetist Fee$10.10
Effective: April 1, 2025
Category
G. Diagnostic Ultrasound
Subcategory
DIAGNOSTIC ULTRASOUND
Service Type
Diagnostic
Code Classes
Diagnostic Ultrasound
Referral RequiredFrom: Physician, NursePractitioner, Midwife, DentalSurgeon
The device used must produce a hard copy output.
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