J836 – Static renal scintigraphy
OHIP Cardio-Thoracic Surgery Code — NUCLEAR MEDICINE - IN VIVO · Schedule of Benefits
Static renal scintigraphy is a diagnostic nuclear medicine procedure. The service is comprised of two distinct, separately billable components as per : 1. Professional Component ('P' Fee): This covers the physician's work in interpreting the scan and providing a report. It is claimed using the fee code with a 'C' suffix (e.g., J836C). 2. Technical Component ('H' Fee): This covers the cost of the facility, equipment, supplies, and technical personnel for performing the scan. It is claimed using the fee code with a 'B' suffix (e.g., J836B). Specific payment rules and restrictions apply to each component.
When to Use
- Use J836C for the professional interpretation and reporting of a static renal scintigraphy scan when performed in a hospital or clinic setting.
- Use J836B to claim the technical component when you own or operate the equipment and are responsible for the data acquisition and quality assurance process.
- Use this code for static imaging studies of the kidneys; do not use it for dynamic renal flow studies, which are covered under separate codes like J835.
Common Pitfalls
- Failing to bill the professional (C) and technical (B) components separately will result in incomplete reimbursement for the service provided.
- Attempting to bill J836 without a valid referral from another physician or oral maxillofacial surgeon as required by GP11.
- Submitting the technical component (J836B) without maintaining the mandatory quality assurance documentation, which is a common trigger for audit recovery.
Billing Tips
- Ensure the professional component (J836C) is supported by a formal, signed report in the patient's medical record to satisfy documentation requirements.
- If providing urgent, non-elective interpretations in a hospital setting after hours, ensure you select the appropriate travel premium (C102-C104) or special visit premium (C108-C110) rather than attempting to add fees to the base J836 code.
Effective: April 1, 2025
B. Nuclear Medicine - IN VIVO
NUCLEAR MEDICINE - IN VIVO
Diagnostic
Nuclear Medicine - IN VIVO
For the Technical Component: The physician submitting a claim must have the necessary training and experience, and maintain documentation describing the quality assurance process. The physician is responsible for all elements of the technical component including data acquisition, reporting, and record keeping.
For the Professional Component: A report with findings and opinion must be included in the patient's medical record.
This service is listed with a technical component ('H' fee) and a professional component ('P' fee). Per , the technical component is claimed with suffix B and the professional component with suffix C.
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