J861 – Radionuclide lymphangiogram
OHIP Cardio-Thoracic Surgery Code — NUCLEAR MEDICINE - IN VIVO · Schedule of Benefits
Radionuclide lymphangiogram is an in-vivo nuclear medicine diagnostic imaging procedure. This service consists of two components: a professional component (Fee P) for the physician's interpretation and report, and a technical component (Fee H) which covers the cost of the facility, equipment, and technical staff. The professional component is paid to the physician. The technical component is generally paid to the hospital or an Independent Community Health Services Centre (ICHSC). For specific payment rules regarding the technical component, see the eligibility rules. See and for details on professional and technical components.
When to Use
- Use J861 when performing a lymphoscintigraphy procedure to map sentinel lymph nodes in patients with melanoma or breast cancer.
- Select J861 for diagnostic imaging of lymphatic drainage patterns when clinical suspicion of lymphedema requires nuclear medicine visualization.
Common Pitfalls
- Billing J861 without a formal written referral from a physician or oral maxillofacial surgeon will result in an automatic rejection.
- Attempting to bill the technical component (Fee H) without maintaining the mandatory quality assurance documentation as specified in GP11 is a significant audit risk.
Billing Tips
- Ensure the professional component is claimed only when the physician has personally interpreted the images and generated a formal diagnostic report.
Effective: April 1, 2025
B. Nuclear Medicine - IN VIVO
NUCLEAR MEDICINE - IN VIVO
Diagnostic
Nuclear Medicine - IN VIVO
To claim the technical component, the physician must maintain documentation that describes the process by which the physician monitors quality assurance in accordance with professional standards.
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