J887 – Ventilation lung scintigraphy
OHIP Cardio-Thoracic Surgery Code — NUCLEAR MEDICINE - IN VIVO · Schedule of Benefits
Ventilation lung scintigraphy is a diagnostic nuclear medicine imaging procedure. The amount payable is separated into a technical component (H fee) and a professional component (P fee). The technical component covers the provision of premises, equipment, supplies, personnel, administration of the radiopharmaceutical, and image acquisition (, ). The professional component covers the interpretation of the images and the provision of a report (). This procedure is often performed with perfusion lung scintigraphy (J859) to evaluate for pulmonary embolism. If both perfusion and ventilation scintigraphy are performed on the same day, J860 must be claimed instead (``).
When to Use
- Use J887 when performing a standalone ventilation lung scintigraphy study for diagnostic purposes.
- Use J887 when the ventilation component is required for clinical correlation but is not performed in conjunction with a perfusion study (J859) on the same day.
Common Pitfalls
- Claiming J887 when a combined ventilation and perfusion study is performed; you must use J860 instead to avoid rejection.
- Failing to distinguish between the technical (H) and professional (P) components when submitting claims, as the code is not payable as a single service.
- Attempting to bill J887 alongside J859, which triggers a mandatory restriction because the combined procedure J860 is the required billing entity.
Billing Tips
- Ensure your documentation clearly separates the technical quality assurance records from the professional interpretation report to satisfy MOH audit requirements for the respective components.
- When providing urgent after-hours services in a hospital setting, verify that the patient meets the criteria for non-elective diagnostic services before appending the appropriate Special Visit Premium.
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 physician must have the necessary training and experience to personally render the technical component of the service.
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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