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J868
J868 – Adrenal scintigraphy with iodocholesterol and dexamethasone suppression
OHIP Cardio-Thoracic Surgery Code — NUCLEAR MEDICINE - IN VIVO · Schedule of Benefits
Adrenal scintigraphy with iodocholesterol and dexamethasone suppression is a nuclear medicine diagnostic procedure for the endocrine system. The fee is divided into a technical component ('H' Fee) and a professional component ('P' Fee).
When to Use
- Use J868 specifically for adrenal cortex imaging when dexamethasone suppression is required to differentiate between adrenal adenoma and hyperplasia.
- Select J868 over J816 or J869 when the clinical protocol necessitates the specific use of iodocholesterol as the radiopharmaceutical agent for adrenal visualization.
Common Pitfalls
- Billing J868 without a valid physician or oral maxillofacial surgeon referral, which is a mandatory requirement for this diagnostic procedure.
- Attempting to bill J868 in conjunction with other special visit premiums (e.g., C109, C108) when the service is performed outside of an acute care hospital setting or via remote interpretation.
Billing Tips
- Ensure the claim clearly distinguishes between the technical 'H' fee and the professional 'P' fee components to avoid automatic rejection during processing.
Provider Fee$0.00
Specialist Fee$0.00
Surgical Assistant Fee$462.85
Anaesthetist Fee$0.00
Non-Anaesthetist Fee$54.70
Effective: April 1, 2005
Category
B. Nuclear Medicine - IN VIVO
Subcategory
NUCLEAR MEDICINE - IN VIVO
Service Type
Diagnostic
Code Classes
Nuclear Medicine - IN VIVO
Referral RequiredFrom: Physician, OralMaxillofacialSurgeon
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