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J207
J207 – Duplex assessment of patency obstruction, and flow direction of vascular shunts
OHIP Cardio-Thoracic Surgery Code — DIAGNOSTIC ULTRASOUND · Schedule of Benefits
Duplex assessment of patency obstruction, and flow direction of vascular shunts. The procedure must include doppler interrogation and documentation of the vascular shunts. This service is not to be billed unless the study has been specifically requested by a referring provider.
When to Use
- Use J207 for the duplex assessment of a dialysis access graft or fistula to evaluate for stenosis, thrombosis, or flow abnormalities.
- Use this code when a referring physician specifically requests a vascular shunt assessment to investigate clinical signs of access failure, such as a change in the thrill or bruit.
Common Pitfalls
- Billing J207 without a formal, documented request from a referring provider will lead to audit recovery as the referral is a mandatory requirement.
- Failing to document specific Doppler interrogation findings, such as peak systolic velocities or flow direction, is a common cause for claim rejection or clawback.
Billing Tips
- Ensure the clinical indication for the shunt assessment is clearly linked to the referring provider's request in your report to satisfy the mandatory referral requirement.
- Do not bundle J207 with general vascular ultrasound codes like J206; ensure the service specifically targets the shunt anatomy to maintain billing integrity.
Provider Fee$0.00
Surgical Assistant Fee$23.30
Anaesthetist Fee$14.20
Non-Anaesthetist Fee$14.20
Effective: April 1, 2025
Category
G. Diagnostic Ultrasound
Subcategory
DIAGNOSTIC ULTRASOUND
Service Type
Diagnostic
Code Classes
Diagnostic Ultrasound
Referral RequiredFrom: Physician, NursePractitioner, OralMaxillofacialSurgeon
Must include doppler interrogation and documentation of vascular shunts.
Not to be billed unless study specifically requested by referring provider.
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