J827 – Oesophageal motility studies
OHIP Cardio-Thoracic Surgery Code — NUCLEAR MEDICINE - IN VIVO · Schedule of Benefits
This service, "Oesophageal motility studies - one or more", is a diagnostic test within the Gastrointestinal System sub-category of Nuclear Medicine. It is used to evaluate the movement and function of the oesophagus. The fee is split into a technical component ('H' fee of $118.90) and a professional component ('P' fee of $40.30), which are billed separately using suffixes B and C, respectively, as per of the Schedule of Benefits. The "one or more" designation indicates that the fee covers all studies performed in a single session.
When to Use
- Use J827 when performing a nuclear medicine study specifically to assess esophageal transit or motility, distinct from general gastrointestinal imaging like J821 or J823.
- Apply this code when the study is completed in a single session, as the 'one or more' designation precludes billing multiple units for additional esophageal motility assessments on the same day.
Common Pitfalls
- Failing to split the billing into the technical component (suffix B) and professional component (suffix C) will result in claim rejection or payment errors.
- Billing J827 alongside other GI nuclear medicine codes (e.g., J821) without clear clinical documentation of distinct, medically necessary procedures risks an audit for unbundling.
Billing Tips
- Ensure the technical component (suffix B) claim includes documentation of the quality assurance process, as the billing physician is held accountable for the entire technical acquisition and reporting chain.
Effective: April 1, 2025
B. Nuclear Medicine - IN VIVO
NUCLEAR MEDICINE - IN VIVO
Diagnostic
Nuclear Medicine - IN VIVO
All insured services must be documented in appropriate records. The Act requires that the record establish that: 1. an insured service was provided; 2. the service for which the account is submitted is the service that was rendered; and 3. the service was medically necessary. The medical record requirements as found in the Act are listed in Appendix G of the Schedule.
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.
one or more
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