J819 – Application of tomography (SPECT)
OHIP Cardio-Thoracic Surgery Code — NUCLEAR MEDICINE - IN VIVO · Schedule of Benefits
This is an add-on service for the application of tomography (SPECT) to be claimed with J852 (Gallium scintigraphy, general survey). It applies when each SPECT image represents a different organ or body area. A maximum of 3 images per examination may be claimed. This service is comprised of a professional component (P fee) and a technical component (H fee). The amount payable to the physician is for the professional component ($24.65). The technical component (H fee) is $43.50.
When to Use
- Use J819 as an add-on to J852 when performing SPECT imaging to localize Gallium uptake in distinct anatomical regions, such as separate thoracic and abdominal scans.
- Claim J819 when the clinical protocol requires cross-sectional tomographic imaging to clarify findings from the general Gallium survey (J852) for up to three distinct body areas.
Common Pitfalls
- Claiming J819 more than three times per examination will result in automatic rejection, as the code is strictly capped at a maximum of three images per patient encounter.
- Attempting to bill J819 without a corresponding J852 claim will lead to a rejection, as J819 is a mandatory add-on service for Gallium scintigraphy.
- Billing J819 for multiple images of the same organ or body area is an audit risk; each claimed unit must represent a distinct anatomical region.
Billing Tips
- Ensure the professional component is billed under your provider number while the technical component (H fee) is only claimed if the equipment is owned or leased by the physician and the service is performed in a non-hospital setting.
Effective: April 1, 2025
B. Nuclear Medicine - IN VIVO
NUCLEAR MEDICINE - IN VIVO
Procedure
Nuclear Medicine - IN VIVO
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