J815 – Detection of venous thrombosis using radioiodinated fibrinogen up to ten days
OHIP Cardio-Thoracic Surgery Code — NUCLEAR MEDICINE - IN VIVO · Schedule of Benefits
This service involves the detection of venous thrombosis using radioiodinated fibrinogen, with monitoring for up to ten days. The fee is claimed once to cover the entire study period. The service is divided into a professional component (P) for interpretation and a technical component (H) for the procedure itself.
When to Use
- Use J815 when performing diagnostic detection of venous thrombosis using radioiodinated fibrinogen, specifically covering the entire monitoring period up to ten days.
- Select J815 for in-patient or out-patient nuclear medicine studies where the clinical objective is the identification of thrombi via fibrinogen uptake, rather than standard ultrasound or venography.
Common Pitfalls
- Attempting to bill J815 multiple times within the ten-day window will result in rejection, as the fee is all-inclusive for the entire study duration.
- Failing to separate the professional component (P) and technical component (H) in your billing submission can lead to processing errors or incorrect payment allocation.
Billing Tips
- When performing this service on an urgent, non-elective basis in a hospital setting, ensure you append the appropriate special visit premium (e.g., C104 or C110) if the criteria for urgent interpretation are met.
Effective: April 1, 2025
B. Nuclear Medicine - IN VIVO
NUCLEAR MEDICINE - IN VIVO
Diagnostic
Nuclear Medicine - IN VIVO
Medical record must establish that an insured service was provided, the service for which the account is submitted is the service that was rendered, and the service was medically necessary.
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.
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