X046 – Acromioclavicular joints (bilateral) - two views
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
Provides for a bilateral X-ray examination of the acromioclavicular joints, with two views taken. The procedure may be performed with or without weighted distraction. This service has both a professional and a technical component, which are billed separately. The technical component (H-fee) is for the performance of the imaging and is claimed with suffix B. The professional component (P-fee) is for the interpretation of the images and is claimed with suffix C. See for details on billing technical and professional components.
When to Use
- Use X046 when ordering or performing a bilateral acromioclavicular joint study requiring exactly two views, regardless of whether weighted distraction is utilized.
- Select X046 over X210 when the clinical request specifies bilateral imaging, as X210 is typically reserved for unilateral or single-joint assessments.
Common Pitfalls
- Failing to append the correct suffix (B for technical, C for professional) will result in automatic claim rejection or incorrect payment processing.
- Billing the technical component (suffix B) without maintaining the mandatory quality assurance documentation required by GP11 creates a significant audit risk.
- Attempting to bill X046 alongside other shoulder or clavicle codes without clear medical necessity for separate views can trigger a review for unbundling.
Billing Tips
- Ensure the technical component (suffix B) and professional component (suffix C) are submitted as distinct line items to reflect the separate fee structure of $21.70 and $10.35 respectively.
Effective: April 1, 2025
D. Diagnostic Radiology
DIAGNOSTIC RADIOLOGY
Diagnostic
Diagnostic Radiology
All insured services must be documented in appropriate records establishing that the service was provided, medically necessary, and is the service submitted for payment as per .
For the technical component, the physician must maintain documentation describing the process for monitoring quality assurance in accordance with professional standards, as outlined on .
This service has separate technical (H-fee) and professional (P-fee) components. The technical fee is $21.70 and the professional fee is $10.35. The technical component claim is submitted with suffix B and the professional component claim with suffix C.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.