X016 – Eye, for foreign body
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
A diagnostic radiology service for the examination of the eye to detect the presence of a foreign body. This service includes both a technical component (H-fee) for the performance of the imaging in a hospital setting and a professional component (P-fee) for the interpretation by a physician.
When to Use
- Use X016 when performing radiographic imaging specifically to rule out or localize a suspected intraocular foreign body following ocular trauma.
- Select X016 over general orbital X-rays when the clinical focus is strictly the detection of a foreign body, as opposed to a general orbital survey.
Common Pitfalls
- Billing X016 as a single code will result in rejection; you must submit the technical component as X016B and the professional interpretation as X016C.
- Attempting to bill X016 for dental-related foreign bodies is an error, as dental X-rays are specifically excluded from insured benefits.
Billing Tips
- Ensure the claim includes the appropriate suffix (B for technical, C for professional) to comply with the mandatory split-billing requirement for diagnostic radiology services.
Effective: April 1, 2025
D. Diagnostic Radiology
DIAGNOSTIC RADIOLOGY
Diagnostic
Diagnostic Radiology
All insured services must be documented in appropriate records. The record must establish that an insured service was provided, the service for which the account is submitted is the service that was rendered, and the service was medically necessary.
Dental x-rays of the teeth are not an insured benefit.
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