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J858
J858 – Brain scintigraphy - except cerebral perfusion
OHIP Nuclear Medicine - IN VIVO Code — NUCLEAR MEDICINE - IN VIVO · Schedule of Benefits
J858 is a nuclear medicine diagnostic procedure for brain scintigraphy. It comprises two distinct components: a technical component (H-fee) and a professional component (P-fee).nn**Billing and Component Rules ():n- Claim Submission:** The technical component is claimed using suffix 'B' (J858B), and the professional component is claimed using suffix 'C' (J858C).n- Technical Component (H-fee) Eligibility:n - The H-fee is not payable if rendered outside of a hospital.n - The H-fee is not payable for hospital in-patients.n - The H-fee is not payable for a patient who receives the service at a hospital and is admitted to the same hospital within 24 hours for the same condition.nnProfessional Component (P-fee) Eligibility:n- The P-fee is for the physician's interpretation and report.n- Eligible for special visit premiums for non-elective, urgent interpretations in a hospital setting (see 'Add-On Eligible Codes' and associated notes).
Referral requiredFrom: Physician, NursePractitioner, DentalSurgeon, OralMaxillofacialSurgeon
The technical component is only eligible for payment where the physician has the necessary training and experience to personally render the technical component of the service.
The physician maintains 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, including data acquisition, reporting, and record keeping.
The fee listed under 'H' is for the technical component (90.40).
The fee listed under 'P' is for the professional component (44.80).
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