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X049
X049 – Scapula - two views
OHIP Diagnostic Radiology Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
This service is for a two-view X-ray examination of the scapula. It is a diagnostic radiology procedure. For three or more views, see billing code X213. As per the Diagnostic Radiology section, this service includes both a technical component (H) and a professional component (P) for interpretation. See general preamble pages and for rules governing payment of diagnostic services and applicable special visit premiums.
Referral requiredFrom: Physician, NursePractitioner, Midwife, OralMaxillofacialSurgeon
All insured services must be documented in appropriate records to establish that: 1. an insured service was provided; 2. the service for which the account is submitted is the service that was rendered; and 3. the service was medically necessary.
The physician submitting a claim for the technical component is responsible for the complete quality assurance process for all elements of the technical component of the service, including data acquisition, reporting, and record keeping. The physician must be able to demonstrate this upon request by the MOH.
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