X054 – Hand - two or three views
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
A diagnostic radiology examination of the hand, including two or three views. This service has both a professional and a technical component. - The claim for the professional component is submitted using the fee schedule code with suffix 'C'. - The claim for the technical component is submitted using the fee schedule code with suffix 'B'. For a study with four or more views, see X219. For rules regarding professional and technical components, refer to .
When to Use
- Use X054 for standard hand radiographs consisting of exactly two or three views, such as a routine PA and oblique or PA, oblique, and lateral.
- Use X054 instead of X219 when the clinical request and resulting study do not exceed three views, as X219 is reserved for four or more views.
Common Pitfalls
- Billing X054 with the wrong suffix; ensure the professional component is billed with 'C' and the technical component with 'B' to avoid automatic rejection.
- Upcoding X054 to X219 for studies with only three views, which constitutes an audit risk for over-billing.
- Attempting to bill a special visit premium for remote interpretation via PACS, as these premiums are strictly for in-person hospital visits.
Billing Tips
- Ensure the technical component (suffix B) is only claimed by the physician or facility assuming full responsibility for the quality assurance and data acquisition process.
- When providing non-elective urgent interpretations in a hospital setting, verify that the patient meets the acute care criteria before appending any applicable special visit premiums (C102-C110).
Effective: April 1, 2025
D. Diagnostic Radiology
DIAGNOSTIC RADIOLOGY
Diagnostic
Diagnostic Radiology
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.
This service is for two or three views.
The professional component fee is $14.90. The technical component fee is $6.40.
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