X017 – Eye, for localization, additional
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
X017 is an additional radiological service for the localization of a foreign body in the eye, typically performed following an initial examination such as X016. This service is comprised of two separately-billed components: - Technical Component (H): The fee paid to the facility where the x-ray is performed. The technical component is only payable when rendered in a hospital and is not payable for hospital in-patients or for out-patients who are subsequently admitted to hospital within 24 hours for the same condition (see ). - Professional Component (P): The fee paid to the physician for interpreting the x-ray and providing a report. Per , claims for diagnostic services with separate technical and professional components are submitted using specific suffixes, which are distinct from surgical suffixes.
When to Use
- Use X017 as an add-on code specifically when performing additional views or specialized localization techniques for a foreign body in the eye following the primary X016 examination.
- Use this code when the clinical complexity of the foreign body localization requires supplementary imaging beyond the standard initial X016 diagnostic study.
Common Pitfalls
- Billing X017 as a standalone service without an associated primary X016 claim will result in automatic rejection as it is defined as an 'additional' service.
- Incorrectly applying surgical suffixes instead of the required diagnostic suffixes (H for technical, P for professional) as mandated by GP11 will lead to claim processing errors.
- Attempting to bill the technical component (H) for hospital in-patients or patients admitted within 24 hours is a violation of GP11 and will trigger an audit recovery.
Billing Tips
- Ensure the professional component (P) is billed by the interpreting physician, while the technical component (H) is billed by the facility, adhering to the distinct suffix requirements for diagnostic radiology services.
Effective: April 1, 2025
D. Diagnostic Radiology
DIAGNOSTIC RADIOLOGY
Diagnostic
Diagnostic Radiology
Dental x-rays of the teeth are not an insured benefit.
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