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J804C
J804C – First Transit - Professional Component
OHIP Cardio-Thoracic Surgery Code — Cardiovascular System · Schedule of Benefits
Professional component (interpretation and report) for a First Transit cardiovascular nuclear medicine study performed without blood pool images. The professional component includes the physician's interpretation of the study and the provision of a written report of the findings (). Claims for the professional component are submitted using the fee schedule code with a suffix C ().
When to Use
- Use J804C when providing the professional interpretation and written report for a First Transit cardiovascular nuclear medicine study that excludes blood pool imaging.
- Select this code when the technical component is billed separately by the facility, as J804C represents only the physician's professional component.
Common Pitfalls
- Billing J804C when blood pool images were actually included in the study, which requires the use of a different fee code instead.
- Attempting to claim Special Visit Premiums (e.g., C109, C110) for interpretations performed remotely via PACS, as these premiums are restricted to services rendered physically within a hospital.
Billing Tips
- Ensure the written report is finalized and dated, as the professional component fee is contingent upon the delivery of this documentation.
- When performing urgent, non-elective interpretations in the hospital, append the appropriate Special Visit Premium (C102-C110) to J804C to maximize reimbursement for after-hours work.
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