J820 – Parathyroid scintigraphy
OHIP Cardio-Thoracic Surgery Code — NUCLEAR MEDICINE - IN VIVO · Schedule of Benefits
Parathyroid scintigraphy - dual isotope technique with T1201 and Tc99m Iodine. This service is a diagnostic procedure with both a technical component (H Fee) and a professional component (P Fee). The claim for the technical component is submitted using the fee schedule code with the suffix B (J820B) and the claim for the professional component is submitted using the fee schedule code with a suffix C (J820C). As per , the technical component is not payable if rendered to a hospital in-patient or a patient admitted within 24 hours of the service for the same condition. The technical component is also not payable if rendered outside of a hospital. To claim the technical component, the physician must have the necessary training and experience and maintain quality assurance documentation.
When to Use
- Use J820 for the localization of a parathyroid adenoma in patients with confirmed biochemical hyperparathyroidism, such as elevated serum PTH and hypercalcemia.
- Use J820 when surgical intervention is planned and anatomical localization is required to guide the operative approach.
Common Pitfalls
- Billing J820B for services performed in a non-hospital setting, which is strictly prohibited by the Schedule of Benefits.
- Submitting J820 for patients with incidental parathyroid-like nodules found on CT or ultrasound without accompanying biochemical evidence of hyperparathyroidism, leading to automatic rejection.
- Attempting to bill the technical component (J820B) for hospital in-patients, as this is considered inclusive of hospital global funding.
Billing Tips
- Always split the claim into J820B for the technical component and J820C for the professional component to ensure both are processed correctly.
- Ensure the referring physician's documentation clearly notes the biochemical evidence of hyperparathyroidism to support the medical necessity of the scan during potential audits.
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.
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