J327 – Flow volume loop - repeat after bronchodilator
OHIP Cardio-Thoracic Surgery Code — PULMONARY FUNCTION STUDIES · Schedule of Benefits
A repeat flow volume loop (volume versus flow) study performed after the administration of a bronchodilator. This service is a repeat of J304 following bronchodilator administration. The study generates an expiratory limb, and an inspiratory limb if indicated. The flow volume loop may include derivation of , VC, , and . The technical component (J327B) of this service rendered in a hospital is payable at 94.68% of the listed T fee. For full requirements, see the CPSO Clinical Practice Parameters and Facility Standards for Diagnostic Spirometry and Flow Volume Loop Studies.
When to Use
- Use J327 only after a baseline J304 has been performed and a bronchodilator has been administered to assess for reversibility of airway obstruction.
- Use this code when documenting the post-bronchodilator response in patients with suspected asthma or COPD to meet the requirement for a complete diagnostic loop.
Common Pitfalls
- Billing J327 without a corresponding J304 on the same day will lead to rejection, as the post-bronchodilator study is dependent on the baseline study.
- Relying on automated computer-generated reports without adding your own signed, written interpretation will result in a clawback during an audit.
- Failing to ensure the printed tracings meet the specific scale requirements (5 mm/L/s for flow and 10 mm/L for volume) renders the service ineligible for payment.
Billing Tips
- Ensure your documentation explicitly states that the results represent the 'best of three' maneuvers, as this is a mandatory requirement for payment eligibility.
- If performing the test in a hospital setting, ensure you are billing the correct component (J327C for professional, J327B for technical) to avoid payment adjustments or errors.
Effective: April 1, 2025
H. Pulmonary Function Studies
PULMONARY FUNCTION STUDIES
Diagnostic
Pulmonary Function Studies, Diagnostic and Therapeutic Procedures
Must represent the best of three recorded test results.
A permanent record must be kept that includes a written interpretation by the physician. A computer or automated interpretation in the absence of a documented physician interpretation is not sufficient.
The permanent record must include constituent graph(s), tracing(s) and measurements with a scale on the tracing or graph of: i. at least 5 mm per litre per second for flow; and ii. 10 mm per litre for volume.
The physician claiming the professional component (J327C) must be able to demonstrate appropriate training in pulmonary function testing interpretation and be prepared to provide documentation of this training to the ministry upon request.
J301 or J324 are not eligible for payment same patient same day as J304 or J327.
J304 and J327 must represent the best of three recorded test results or the study is not eligible for payment.
J304 and J327 are only eligible for payment for a study that meets all of the following requirements: a. There is a permanent record that includes a written interpretation by the physician; b. The permanent record includes constituent graph(s), tracing(s) and measurements with a scale on the tracing or graph of: i. at least 5 mm per litre per second for flow; and ii. 10 mm per litre for volume. c. The technical component of the study complies with the CPSO Clinical Practice Parameters and Facility Standards for Diagnostic Spirometry and Flow Volume Loop Studies; and d. The physician claiming the professional component must be able to demonstrate appropriate training in pulmonary function testing interpretation.
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