X058 – Skeletal survey for bone age - two or more films or views
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
A skeletal survey for bone age assessment which requires two or more films or views for its completion. As a diagnostic radiology service, it has a technical component (H-fee) and a professional component (P-fee) which are claimed separately. The technical component is subject to specific payment rules regarding the location of service, as detailed on page of the Schedule of Benefits. See page for details.
When to Use
- Use X058 when performing a formal bone age assessment requiring two or more radiographic views, typically of the left hand and wrist.
- Select X058 over X057 when the clinical protocol specifically mandates multiple views for a comprehensive skeletal survey assessment rather than a single view.
Common Pitfalls
- Failure to bill the technical (H-fee) and professional (P-fee) components separately will result in incomplete reimbursement.
- Billing X058 without a valid physician or nurse practitioner referral on file is a common cause for audit recovery.
- Claiming X058 for a single-view study is an incorrect application of the code, as the definition explicitly requires two or more films or views.
Billing Tips
- Ensure the technical component claim clearly identifies the location of service, as payment rules for the H-fee vary significantly based on whether the service was rendered in a hospital or independent health facility.
Effective: April 1, 2025
D. Diagnostic Radiology
DIAGNOSTIC RADIOLOGY
Diagnostic
Diagnostic Radiology
The medical record must establish that an insured service was provided, the service for which the account is submitted is the service that was rendered, and 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 the above upon request by the MOH.
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