J901 – Application of Rubidium PET for cardiac perfusion
OHIP Cardio-Thoracic Surgery Code — NUCLEAR MEDICINE - IN VIVO · Schedule of Benefits
This code represents the application of Rubidium PET for cardiac perfusion as an addition to a delayed myocardial perfusion scintigraphy (J808). This service has a maximum of 1 per examination. Payment is conditional on the patient having known or suspected coronary artery disease at an intermediate risk (10-90%) of significant ischemia where the need for intervention is uncertain.
When to Use
- Use J901 as an add-on to J808 for patients with suspected coronary artery disease at intermediate risk (10-90%) where clinical management remains uncertain.
- Apply this code only when the specific indication is listed as an approved 'Routine PET Scan' on the PET Scans Ontario website on the date of service.
Common Pitfalls
- Billing J901 without J808 will result in automatic rejection, as J901 is strictly an add-on code.
- Submitting J901 for indications listed as 'evidence-building' or 'PET Registry' on the PET Scans Ontario website is ineligible for payment and creates audit risk.
- Attempting to bill the technical component for an in-patient or a patient admitted within 24 hours of the service is prohibited.
Billing Tips
- Ensure the technical component (suffix B) and professional component (suffix C) are claimed separately to comply with standard diagnostic billing requirements.
- Verify the patient's risk profile (10-90% ischemia risk) and the current PET Scans Ontario status for the indication prior to submission to avoid retroactive recovery.
No fee information available.
B. Nuclear Medicine - IN VIVO
NUCLEAR MEDICINE - IN VIVO
Diagnostic
Nuclear Medicine - IN VIVO
All insured services must be documented in appropriate records establishing that an insured service was provided, the service claimed is the service rendered, and the service was medically necessary, as per .
The technical component of a diagnostic procedure is only eligible for payment where the physician maintains documentation that describes the process by which the physician monitors quality assurance in accordance with professional standards, as per .
PET Rubidium for cardiac perfusion is only eligible for payment in patients with known coronary artery disease or suspected coronary artery disease at intermediate risk (10-90%) of significant ischemia where the need for intervention is uncertain.
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