J874 – Blood loss using Cr
OHIP Cardio-Thoracic Surgery Code — NUCLEAR MEDICINE - IN VIVO · Schedule of Benefits
J874 is a nuclear medicine test to detect gastrointestinal blood loss using Chromium-51 (Cr⁵¹) labelled red blood cells. The service is comprised of two distinct, separately billable components: - Technical Component (`H`): Covers the cost of the equipment, supplies, and technical staff for performing the test. The fee listed is $61.90. This component is only payable when rendered in a hospital and is subject to specific payment rules outlined in the General Preamble (:). - Professional Component (`P`): Covers the physician's service of interpreting the results and providing a report. The fee listed is $9.70.
When to Use
- Use J874 when performing a formal Chromium-51 red cell survival or sequestration study to quantify occult gastrointestinal blood loss.
- Select J874 over general imaging codes like J821 when the clinical objective is specifically the quantification of blood loss rather than standard organ imaging.
Common Pitfalls
- Failing to bill the technical component (H) and professional component (P) as separate line items will result in incomplete reimbursement.
- Billing the technical component (H) for services rendered outside of a hospital setting is a violation of the General Preamble and will lead to claim rejection.
- Neglecting to maintain the required quality assurance documentation for the technical component will trigger an audit recovery if the MOH requests proof of service.
Billing Tips
- Ensure your billing software correctly appends the 'H' and 'P' suffixes to the J874 code to distinguish between the technical and professional components.
- If performing this test on an urgent, non-elective basis in a hospital, ensure you attach the appropriate Special Visit Premium (e.g., C109 or C110) to maximize the professional claim.
Effective: April 1, 2025
B. Nuclear Medicine - IN VIVO
NUCLEAR MEDICINE - IN VIVO
Diagnostic
Nuclear Medicine - IN VIVO
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 the above upon request by the MOH.
The technical component of a diagnostic procedure as described in the relevant section of the Schedule is only eligible for payment where the physician has the necessary training and experience to personally render the technical component of the service; and the physician maintains documentation that describes the process by which the physician monitors quality assurance in accordance with professional standards.
This service code represents both a technical component (H fee: $61.90) and a professional component (P fee: $9.70), which are claimed separately.
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