J807 – Myocardial Perfusion Scintigraphy - resting, immediate post stress
OHIP Cardio-Thoracic Surgery Code — NUCLEAR MEDICINE - IN VIVO · Schedule of Benefits
A nuclear medicine cardiovascular system procedure for myocardial perfusion scintigraphy, performed at rest or immediately post-stress. The fee listed is broken into two components: the Technical Component (H) and the Professional Component (P). - The fee for the technical component (H) is $217.55. - The fee for the professional component (P) is $38.10. This service can be enhanced with add-on codes for SPECT (J866) or Rubidium PET (J900).
When to Use
- Use J807 for the resting phase of a myocardial perfusion study when the stress phase is performed separately or not at all.
- Use J807 in conjunction with J808 to capture both the resting and stress components of a standard myocardial perfusion scintigraphy examination.
Common Pitfalls
- Failing to submit the technical component (suffix B) and professional component (suffix C) as separate claims, which leads to immediate rejection.
- Billing J900 for PET indications that are currently classified as evidence-building or registry-based rather than approved Routine PET Scans.
- Attempting to bill J809 more than once per examination when paired with J807.
Billing Tips
- Always append suffix B to the technical component claim and suffix C to the professional component claim to ensure correct processing of the split fee structure.
- Verify the current PET Scans Ontario website status for the specific clinical indication before appending J900 to ensure the service is eligible for payment.
Effective: April 1, 2025
B. Nuclear Medicine - IN VIVO
NUCLEAR MEDICINE - IN VIVO
Diagnostic
Nuclear Medicine - IN VIVO
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