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J890
J890 – Diagnostic study in specialized facility
OHIP Diagnostic and Therapeutic Procedures Code — DIAGNOSTIC AND THERAPEUTIC PROCEDURES · Schedule of Benefits
J890 is a Level 1 overnight sleep study with continuous monitoring of oxygen saturation, ECG and Ventilation (airflow and respiratory effort) and additional monitoring to stage sleep (including all of the following: EEG, EOG and sub-mental EMG).
This study must be rendered in a specialized facility, which is defined as:
a. a facility where patients are on ventilatory support and that specializes in the treatment of adults with conditions such as amyotropic lateral sclerosis or polio; or
b. a paediatric hospital where there is a Paediatric ICU and that treats children with respiratory control disorders.
This service includes a professional component (P Fee) and a technical component (H Fee).
Referral requiredFrom: Physician, NursePractitioner
All insured services must be documented in appropriate records that establish: 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. (:)
For the technical component, the physician must maintain documentation that describes the process by which the physician monitors quality assurance in accordance with professional standards. (:)
Except where prior approval is given, overnight sleep studies rendered in specialized facilities are limited to two per patient, per 12 month period for any combination of such studies (J890, J889).
For services rendered on or after July 1, 2010, the 12 month period is determined from July 1, 2009 onwards.
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