X034 – Sacrum and/or coccyx - two views
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
X034 is a diagnostic radiology procedure for two views of the sacrum and/or coccyx. The payment for this service is divided into two parts: a technical component (H-fee), which covers the cost of the equipment and facility, and a professional component (P-fee), which is for the physician's interpretation of the images. As per the rules on page of the Schedule, the technical component is generally not payable for services rendered to hospital in-patients or for services performed outside of a hospital setting.
When to Use
- Use X034 when exactly two radiographic views of the sacrum and/or coccyx are performed and interpreted.
- Use X034 for standard diagnostic imaging requests; if the clinical requirement necessitates three or more views, you must bill X207 instead.
Common Pitfalls
- Billing X034 in addition to X207 for the same anatomical site on the same day is a duplicate billing error.
- Attempting to claim the technical component (H-fee) for hospital in-patients or services performed outside of a hospital setting will result in automatic rejection.
- Claiming a Special Visit Premium (C102-C110) for services rendered remotely via PACS is prohibited and will be flagged during audit.
Billing Tips
- Ensure the total view count is explicitly documented in the report to justify the selection of X034 over X207.
- When providing urgent after-hours interpretation in a hospital setting, verify that the service is not rendered via PACS to maintain eligibility for the applicable Special Visit Premium.
Effective: April 1, 2025
D. Diagnostic Radiology
DIAGNOSTIC RADIOLOGY
Diagnostic
Diagnostic Radiology
This service is for two views. For three or more views, see X207.
This service has a technical component (H-fee) of $23.95 and a professional component (P-fee) of $6.40.
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