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J319
J319 – Blood gas analysis
OHIP Cardio-Thoracic Surgery Code — PULMONARY FUNCTION STUDIES · Schedule of Benefits
J319 is a pulmonary function study for blood gas analysis. It measures pH, , , bicarbonate, and base excess. This billing code represents the technical component (H Fee), which is performed in a hospital setting for an out-patient. No professional component (P Fee) is payable for this service.
When to Use
- Use J319 when performing an arterial blood gas analysis for an out-patient in a hospital setting to assess pH, PO2, and PCO2 levels.
- Select J319 specifically for the technical component of the test when the laboratory or hospital facility requires a separate billing entry for the procedure itself, distinct from professional interpretation.
Common Pitfalls
- Billing J319 for an in-patient will result in an automatic rejection, as the technical component is included in the hospital's global budget for in-patients.
- Submitting J319 for a patient who is admitted to the hospital within 24 hours of the test for the same condition will trigger a recovery, as this is considered part of the admission process.
- Attempting to bill J319 in a private clinic or office setting is ineligible, as the code is strictly restricted to hospital-based out-patient services.
Billing Tips
- Ensure the service is strictly for an out-patient; if the patient is admitted to the hospital within the 24-hour window, do not submit J319 to avoid audit flags.
- Since J319 is a technical component (H-fee), do not attempt to add a professional interpretation fee (P-fee) to the claim, as no professional component is payable for this specific code.
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