J849 – Red cell survival with serial surface counts
OHIP Cardio-Thoracic Surgery Code — NUCLEAR MEDICINE - IN VIVO · Schedule of Benefits
Red cell survival with serial surface counts is an in-vivo nuclear medicine procedure within the Haematopoietic System category. It is designed to measure the lifespan of red blood cells in circulation and includes tracking them via serial surface counts. The Schedule of Benefits lists a technical component (H) fee of $148.25 and a professional component (P) fee of $27.10. The technical component covers the operational aspects of the test, while the professional component covers the physician's interpretation and report. See for rules on billing technical and professional components.
When to Use
- Use J849 when quantifying red cell sequestration sites (e.g., spleen vs. liver) in patients with suspected autoimmune hemolytic anemia or hypersplenism.
- Use J849 to differentiate between primary bone marrow failure and peripheral destruction when standard hematological indices are inconclusive.
Common Pitfalls
- Billing the technical component (H) fee directly as a physician; this is intended for the facility and will result in rejection if claimed by the professional provider.
- Failing to document the specific quality assurance monitoring process required by GP8 and GP11, which is a common trigger for audit recovery.
- Attempting to bill J849 alongside other red cell studies (e.g., J841 or J847) without clear clinical justification for separate procedures, which may lead to claims being flagged for duplication.
Billing Tips
- Ensure the professional component (P) is billed only after the formal interpretation and report are finalized and filed in the patient's record.
- When performing this service on an urgent basis in a hospital setting, verify eligibility for C102, C103, or C104 premiums to maximize reimbursement for non-elective diagnostic work.
Effective: April 1, 2025
B. Nuclear Medicine - IN VIVO
NUCLEAR MEDICINE - IN VIVO
Diagnostic
Nuclear Medicine - IN VIVO
In addition to standard medical record requirements as per , the physician claiming the technical component must maintain documentation describing the quality assurance monitoring process, in accordance with professional standards. See .
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