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X050
X050 – Humerus including one joint - two views
OHIP Diagnostic Radiology Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
A diagnostic radiological examination of the humerus including one joint, consisting of two views. The service is listed with a technical component (H) and a professional component (P). For three or more views, see X214.
Referral requiredFrom: Physician, NursePractitioner, OralMaxillofacialSurgeon
All insured services must be documented in appropriate records. The Act requires that the record 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.
The technical component of a diagnostic procedure as described in the relevant section of the Schedule is only eligible for payment where: 1. the physician has the necessary training and experience to personally render the technical component of the service; and 2. the physician maintains documentation that describes the process by which the physician monitors quality assurance in accordance with professional standards.
The fee listed after the slash (6.40) is the professional component ('P' fee). The technical component ('H' fee) can be calculated by subtracting the 'P' fee from the total fee (14.90).
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