J200 – Ankle pressure measurements
OHIP Cardio-Thoracic Surgery Code — DIAGNOSTIC ULTRASOUND · Schedule of Benefits
Ankle pressure measurements involves a minimum of 4 segmental pressure recordings and/or pulse volume recordings and/or Doppler recordings. It may be performed on one or both legs (unilateral or bilateral). This service has separate technical and professional fee components: * Technical Component (H): $20.40 * Professional Component (P): $21.40
When to Use
- Use J200 when performing a comprehensive vascular assessment requiring at least 4 segmental pressure or pulse volume recordings, which exceeds the scope of a simple Ankle-Brachial Index (ABI) assessment.
- Select J200 instead of G517 when the clinical protocol requires detailed segmental pressures to localize arterial occlusive disease rather than a basic screening ABI.
Common Pitfalls
- Billing J200 alongside G517 is a common audit trigger as they are mutually exclusive; you must choose the code that best reflects the complexity of the diagnostic procedure performed.
- Claiming the technical component without maintaining a formal quality assurance log for the diagnostic equipment will result in clawbacks during a Ministry audit.
- Failure to produce and retain a hard copy output from the diagnostic device renders the service ineligible for payment.
Billing Tips
- Always append the J196 add-on code if the assessment includes exercise testing or quantitative measurements, provided the hard copy documentation supports the additional data points.
Effective: April 1, 2025
G. Diagnostic Ultrasound
DIAGNOSTIC ULTRASOUND
Diagnostic
Diagnostic Ultrasound
When claiming the technical component, the physician must maintain documentation that describes the process by which the physician monitors quality assurance in accordance with professional standards.
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