X027 – Thoracic spine - two views
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
This service is for a diagnostic X-ray of the thoracic spine, which includes the capture of two views. The service is comprised of a technical component (the 'H' fee), covering the procedure of taking the images, and a professional component (the 'P' fee), for the physician's interpretation and report. Payment for each component is subject to specific rules based on the location of service.
When to Use
- Use X027 when a standard two-view thoracic spine series (typically AP and lateral) is performed for diagnostic purposes.
- Select X027 over X028 when the clinical request specifically necessitates only two views rather than a more comprehensive multi-view series.
Common Pitfalls
- Billing the technical component (H-fee) for hospital in-patients is a common rejection, as this is included in the hospital's global budget.
- Attempting to bill X027 in addition to X028 for the same patient encounter is a frequent audit trigger for unbundling services.
Billing Tips
- Ensure the referral source is documented as a physician, nurse practitioner, midwife, or oral maxillofacial surgeon to satisfy the mandatory referral requirement.
- Verify that the technical component is only billed for outpatient services rendered outside of a hospital setting, as per the Health Insurance Act.
Effective: April 1, 2025
D. Diagnostic Radiology
DIAGNOSTIC RADIOLOGY
Diagnostic
Diagnostic Radiology
The medical 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.
For the technical component, the physician must have the necessary training and experience and must maintain documentation describing the process for monitoring quality assurance in accordance with professional standards.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.