J290 – Spinal sonography
OHIP Cardio-Thoracic Surgery Code — DIAGNOSTIC ULTRASOUND · Schedule of Benefits
Spinal sonography is a diagnostic ultrasound imaging service. The amount payable for J290 is for the professional component ('P' fee) only, which includes the physician's interpretation of the images and the creation of a written report. According to the rules for diagnostic services in the General Preamble (), this professional service must be rendered personally by the physician. The service is insured when referred by a physician, a nurse practitioner, or an oral and maxillofacial surgeon under specific conditions ().
When to Use
- Use J290 for the professional interpretation of spinal sonography when performed to assess spinal dysraphism or other congenital spinal anomalies in pediatric patients.
- Use J290 when performing a focused ultrasound assessment of the spinal canal or cord structures that does not meet the criteria for more complex diagnostic imaging codes.
Common Pitfalls
- Billing J290 for studies performed via teleradiology or PACS interpretation from outside the hospital setting, as this violates the requirement for the service to be rendered personally by the physician.
- Failing to ensure a valid referral from a physician, nurse practitioner, or oral and maxillofacial surgeon is on file, which is a mandatory prerequisite for this insured service.
- Attempting to bill J290 in conjunction with other diagnostic imaging codes without clear clinical justification for separate, distinct procedures.
Billing Tips
- Ensure the written report is finalized and dated at the time of service, as the fee is strictly for the professional component (interpretation and reporting) performed personally by the physician.
- If providing urgent, non-elective interpretation in a hospital setting after hours, verify eligibility for the appropriate C-series travel premiums (C102-C110) to supplement the professional fee.
Effective: April 1, 2025
G. Diagnostic Ultrasound
DIAGNOSTIC ULTRASOUND
Diagnostic
Diagnostic Ultrasound
All insured services must be documented in appropriate records to establish that an insured service was provided, the service for which the account is submitted is the service that was rendered, and the service was medically necessary.
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