J808 – Myocardial Perfusion Scintigraphy - delayed
OHIP Cardio-Thoracic Surgery Code — NUCLEAR MEDICINE - IN VIVO · Schedule of Benefits
Represents the delayed phase of a myocardial perfusion scintigraphy study. This diagnostic procedure involves nuclear imaging of the heart muscle to assess blood flow after a period of rest or delay, typically following an initial stress test (J807). It is used to evaluate cardiac health, particularly in patients with known or suspected coronary artery disease. This service is comprised of a professional component ('P' fee) for interpretation and a technical component ('H' fee) for the scan itself, which are billed separately.
When to Use
- Use J808 for the delayed phase of a myocardial perfusion study following the initial stress phase billed under J807.
- Use J808 when performing resting myocardial perfusion scintigraphy as part of a complete cardiac evaluation protocol.
Common Pitfalls
- Billing the technical component (H) for hospital in-patients, which is explicitly excluded by OHIP payment rules.
- Attempting to bill J809 more than twice per examination, as the system will reject any quantity exceeding the maximum limit.
- Claiming the non-elective diagnostic premiums for interpretations performed remotely via PACS, which are ineligible for these specific night/weekend/evening codes.
Billing Tips
- Always pair J808 with the appropriate add-on code J809 (SPECT) or J901 (Rubidium PET) when applicable to ensure full capture of the technical and professional effort.
- Ensure the referral source is clearly documented in the patient record, as J808 requires a valid referral from a physician, nurse practitioner, or oral maxillofacial surgeon.
Effective: April 1, 2025
B. Nuclear Medicine - IN VIVO
NUCLEAR MEDICINE - IN VIVO
Diagnostic
Nuclear Medicine - IN VIVO
For the technical component, the physician must maintain documentation that describes the process by which the physician monitors quality assurance in accordance with professional standards.
All insured services must be documented in appropriate records establishing that an insured service was provided, the service claimed is the service that was rendered, and the service was medically necessary.
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