J851 – Bone scintigraphy - single site
OHIP Cardio-Thoracic Surgery Code — NUCLEAR MEDICINE - IN VIVO · Schedule of Benefits
J851 represents a bone scintigraphy, or bone scan, of a single site. This is a nuclear medicine diagnostic procedure. Billing Components: This service has two distinct components as indicated in the Schedule of Benefits: - H (Technical) Component: Covers the cost of equipment, supplies, and technical staff. - P (Professional) Component: Covers the physician's service of interpreting the scan and providing a report. As per of the Schedule, the technical and professional components of diagnostic services are claimed separately. The claim for the technical component is submitted using the fee code with suffix 'B' (e.g., J851B), and the claim for the professional component uses suffix 'C' (e.g., J851C). **Payment Rules from Target Page :** - J850 (general survey) and J851 (single site) are not to be billed together. - J804 (blood pool study) may be claimed in addition to J850 or J851.
When to Use
- Use J851 for targeted bone scintigraphy when the clinical question is limited to a single anatomical site, such as a localized fracture or specific lesion, rather than a whole-body survey.
- Use J851 in conjunction with J804 when a first transit study is required to assess blood flow to a specific site of interest.
Common Pitfalls
- Billing J851 and J850 together is a common error that will result in a rejection; choose the code that best reflects the scope of the examination.
- Attempting to bill the technical component (J851B) for hospital in-patients or patients admitted within 24 hours is a violation of GP11 and will trigger a recovery.
- Failing to separate the technical (B suffix) and professional (C suffix) components into two distinct claims will lead to processing errors.
Billing Tips
- Ensure the professional component (J851C) is supported by a formal, documented interpretation report that meets the quality assurance standards required by GP11.
- When performing a first transit study, ensure J804 is billed alongside J851C to capture the additional professional fee for that specific component.
Effective: April 1, 2025
B. Nuclear Medicine - IN VIVO
NUCLEAR MEDICINE - IN VIVO
Diagnostic
Nuclear Medicine - IN VIVO
When claiming the technical component, the physician must have the necessary training and experience to personally render the technical component of the service.
When claiming the technical component, the physician must maintain documentation that describes the process by which the physician monitors quality assurance in accordance with professional standards.
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.
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