J806 – First pass for shunt detection, cardiac output and transit studies
OHIP Cardio-Thoracic Surgery Code — NUCLEAR MEDICINE - IN VIVO · Schedule of Benefits
J806 is for cardioangiography, specifically the first pass for shunt detection, cardiac output and transit studies. This service is comprised of two separately billable components: - Technical Component (H): Covers the use of equipment, facilities, and technical staff. Claimed as J806B. - Professional Component (P): Covers the physician's work in interpreting the study and providing a report. Claimed as J806C. The rules for billing these components are outlined in of the Schedule.
When to Use
- Use J806 for the initial assessment of intracardiac shunts using radionuclide angiocardiography.
- Use J806 for calculating cardiac output or evaluating pulmonary transit times when standard echocardiography is inconclusive.
- Use J806 for assessing hemodynamic transit studies in patients with suspected congenital heart disease where first-pass kinetics are required.
Common Pitfalls
- Failing to split the claim into J806B for the technical component and J806C for the professional component, which will result in an automatic rejection.
- Attempting to bill J806 in conjunction with other diagnostic imaging codes for the same anatomical study, which may trigger a duplicate service audit.
- Billing the professional component (J806C) without maintaining the required documentation of the interpretation and report in the patient record.
Billing Tips
- Ensure the technical component (J806B) is only claimed if your facility maintains the quality assurance records for the equipment and data acquisition as mandated by GP11.
- When providing urgent after-hours interpretation, ensure you select the appropriate Special Visit Premium (e.g., C104 or C110) rather than attempting to add a premium to the J806 code itself.
Effective: April 1, 2025
B. Nuclear Medicine - IN VIVO
NUCLEAR MEDICINE - IN VIVO
Diagnostic
Nuclear Medicine - IN VIVO
For the technical component, the physician submitting a claim is responsible for the complete quality assurance process for all elements of the technical component of the service, including data acquisition, reporting, and record keeping. The physician must be able to demonstrate this upon request by the MOH.
This service is listed with a Technical Component (H fee: $95.10) and a Professional Component (P fee: $41.70). These components must be billed separately using suffixes 'B' for the technical component and 'C' for the professional component, as per .
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