J710 – Esophageal carcinoma PET scan
OHIP Cardio-Thoracic Surgery Code — POSITRON EMISSION TOMOGRAPHY (PET) · Schedule of Benefits
J710 is a Positron Emission Tomography (PET) scan payable for esophageal carcinoma under the following conditions: - a. Baseline staging assessment of those patients diagnosed with esophageal cancer being considered for curative therapy. - b. Repeat PET/CT scan on completion of pre-operative/neoadjuvant therapy, prior to surgery.
When to Use
- Use J710 for the initial baseline staging PET/CT scan when a patient with confirmed esophageal carcinoma is being actively evaluated for curative-intent surgery or definitive chemoradiation.
- Use J710 for a repeat PET/CT scan specifically after the completion of neoadjuvant therapy to assess response prior to proceeding with surgical resection.
Common Pitfalls
- Billing J710 for routine surveillance or follow-up scans in patients with metastatic disease or those not candidates for curative therapy will result in automatic rejection.
- Failure to clearly document the specific clinical phase—either baseline staging for curative intent or post-neoadjuvant re-staging—is a frequent cause of audit recovery.
Billing Tips
- Ensure the referring physician's order explicitly states the intent for curative therapy or the completion of neoadjuvant therapy to satisfy the specific coverage criteria for J710.
Effective: April 1, 2012
B. Nuclear Medicine - IN VIVO
POSITRON EMISSION TOMOGRAPHY (PET)
Diagnostic
Positron Emission Tomography (PET)
The patient's permanent medical record must document the diagnosis of esophageal carcinoma and the clinical indication for the PET scan, either for baseline staging for curative therapy or for a repeat scan post-neoadjuvant therapy prior to surgery.
General medical record requirements as per must be met.
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