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J865
J865 – Total body counting including dosimetry
OHIP Nuclear Medicine - IN VIVO Code — NUCLEAR MEDICINE - IN VIVO · Schedule of Benefits
J865 is a nuclear medicine procedure for total body counting. Payment is divided into a professional component (Fee P) covering the physician's interpretation, and a technical component (Fee H) covering the cost of the equipment, supplies, and technical personnel. The technical component is subject to specific payment rules, including restrictions on payment when rendered outside of a hospital or for patients who are subsequently admitted. Tomography (SPECT) may be added using J866.
Referral requiredFrom: Physician, NursePractitioner, OralMaxillofacialSurgeon
All insured services must be documented in appropriate records. The Act requires that the record establish that:
1. an insured service was provided;
2. the service for which the account is submitted is the service that was rendered; and
3. the service was medically necessary. (From )
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. The physician must be able to demonstrate this upon request by the MOH. (From )
This service is billed as two separate components: a professional component (P) and a technical component (H). The professional component is for the physician's interpretation, and the technical component covers the facility, equipment, and staff costs.
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