J813 – Myocardial wall motion studies with ejection fraction
OHIP Cardio-Thoracic Surgery Code — NUCLEAR MEDICINE - IN VIVO · Schedule of Benefits
A diagnostic imaging procedure to assess the heart's pumping function, specifically including a myocardial wall motion study with the calculation and reporting of the ejection fraction. This service has both a technical component ('H' fee) and a professional component ('P' fee). The note from the Schedule indicates that J811 and/or J812 rendered in conjunction with J813 are insured services payable at nil.
When to Use
- Use J813 when performing a MUGA scan or gated equilibrium radionuclide angiocardiography specifically to calculate and report the left ventricular ejection fraction.
- Use this code when the clinical requirement is a quantitative assessment of myocardial wall motion and ejection fraction, rather than simple myocardial perfusion imaging.
Common Pitfalls
- Do not bill J811 or J812 on the same day as J813, as these are explicitly listed as payable at nil when rendered in conjunction with J813.
- Failing to document the specific ejection fraction calculation in the report, which is a mandatory requirement for the professional component of J813.
Billing Tips
- Ensure the claim includes both the technical ('H') and professional ('P') components if you are responsible for both the data acquisition quality assurance and the final interpretation.
Effective: April 1, 2025
B. Nuclear Medicine - IN VIVO
NUCLEAR MEDICINE - IN VIVO
Diagnostic
Nuclear Medicine - IN VIVO, Diagnostic and Therapeutic Procedures
The physician submitting a claim for the technical component 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.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.