X035 – Sacro-iliac joints - two or three views
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
A diagnostic radiology service for the sacro-iliac joints, consisting of two or three views. This service is comprised of a technical component (H fee) for performing the imaging and a professional component (P fee) for the interpretation and report. As per , for diagnostic services with separate components, claims for the professional component should be submitted with suffix C and the technical component with suffix B.
When to Use
- Use X035 when ordering a standard two or three-view radiographic assessment of the sacro-iliac joints for suspected inflammatory arthropathy or mechanical dysfunction.
- Use this code instead of X208 when the clinical requirement is specifically limited to a standard sacro-iliac joint series rather than a more comprehensive pelvic or spinal survey.
Common Pitfalls
- Failing to split the claim into suffix B for the technical component and suffix C for the professional component will result in automatic rejection.
- Attempting to claim special visit premiums (e.g., C102-C110) for interpretations performed via remote PACS systems is ineligible, as these premiums require a physical presence in the hospital.
Billing Tips
- Ensure the professional component (suffix C) is only billed by the interpreting radiologist, while the technical component (suffix B) reflects the facility's imaging service.
Effective: April 1, 2025
D. Diagnostic Radiology
DIAGNOSTIC RADIOLOGY
Diagnostic
Diagnostic Radiology
As with all insured services, appropriate medical records must be kept to establish that the service was provided and was medically necessary, as per .
When claiming special visit premiums, the time of the request to attend and the time of the transmission of the interpretation must be documented on the patient's permanent medical record as per .
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