J810 – Myocardial scintigraphy - acute infarction, injury, inflammation, infiltration
OHIP Cardio-Thoracic Surgery Code — NUCLEAR MEDICINE - IN VIVO · Schedule of Benefits
Myocardial scintigraphy for acute infarction or injury. This is a diagnostic procedure from the Nuclear Medicine section of the Schedule. As per , this service has two components: a technical component (H-fee) claimed as J810B and a professional component (P-fee) claimed as J810C. The technical component is for services rendered in a hospital.
When to Use
- Use J810 for myocardial scintigraphy specifically to evaluate acute infarction, myocardial injury, or inflammatory/infiltrative processes when other cardiac imaging codes like J802 or J804 are not clinically appropriate.
- Use this code for emergency department or acute care hospital patients where urgent diagnostic imaging is required to guide immediate management of suspected acute myocardial injury.
Common Pitfalls
- Failing to split the claim into the technical component (J810B) and the professional component (J810C) will result in automatic rejection by OHIP.
- Billing J810 for elective or routine outpatient cardiac screening is inappropriate; this code is strictly intended for acute clinical scenarios as defined in the Schedule.
- Attempting to bill a special visit premium (e.g., C108 or C110) for services rendered outside of a hospital setting or via remote interpretation (PACS) will lead to claim audit and recovery.
Billing Tips
- Ensure the professional component (J810C) is linked to the physician provider number, while the technical component (J810B) is submitted under the hospital facility number to ensure correct payment processing.
- When providing urgent after-hours services, ensure the selected special visit premium (C102-C110) matches the exact time period and patient status to avoid rejection due to mismatching criteria.
Effective: April 1, 2025
B. Nuclear Medicine - IN VIVO
NUCLEAR MEDICINE - IN VIVO
Diagnostic
Nuclear Medicine - IN VIVO
As per , all insured services must be documented in appropriate records. The record must establish 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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