J881 – Bone marrow scintigraphy - whole body
OHIP Cardio-Thoracic Surgery Code — NUCLEAR MEDICINE - IN VIVO · Schedule of Benefits
J881 is a whole body bone marrow scintigraphy, a diagnostic procedure listed in the Nuclear Medicine section. Payment is divided into two components: a Technical Component (H-fee) and a Professional Component (P-fee). According to , the professional component (P) is claimed using suffix 'C' and covers the physician's work in interpreting the scan and providing a report. The technical component (H) is claimed using suffix 'B' and covers the use of equipment, supplies, and technical staff. The technical component is only payable when performed in a hospital for an out-patient and is not payable for hospital in-patients or for out-patients who are subsequently admitted to the hospital within 24 hours for the same condition. The technical component is not eligible for payment if rendered outside of a hospital.
When to Use
- Use J881 for whole-body marrow imaging to evaluate hematologic disorders or metastatic disease when localized bone scans like J882 are insufficient.
- Use J881 when the clinical objective is to assess the distribution of active hematopoietic marrow in patients with suspected marrow failure or myeloproliferative syndromes.
Common Pitfalls
- Claiming the technical component (suffix B) for patients admitted to the hospital within 24 hours of the scan, which triggers an automatic rejection.
- Submitting the technical component (suffix B) for scans performed in a private clinic or office setting, as this component is strictly restricted to hospital-based outpatient services.
- Failing to separate the claim into two distinct submissions, as J881 requires a suffix C for the professional interpretation and a suffix B for the technical facility fee.
Billing Tips
- Ensure the professional component (suffix C) is billed under the interpreting physician's billing number, while the technical component (suffix B) is billed to the hospital facility account where the equipment is located.
Effective: April 1, 2025
B. Nuclear Medicine - IN VIVO
NUCLEAR MEDICINE - IN VIVO
Diagnostic
Nuclear Medicine - IN VIVO
When claiming the technical component, the physician must have the necessary training and experience to personally render the service and must maintain documentation describing the quality assurance process in accordance with professional standards.
The medical record must establish that an insured service was provided, the service submitted is the service rendered, and the service was medically necessary.
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