X064 – Leg length studies (orthoroentgenogram)
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
Leg length studies (orthoroentgenogram) is a diagnostic radiology service. The Schedule lists separate fees for the technical component (X064B, H-fee: $21.70) and the professional component (X064C, P-fee: $10.35). The technical component is for the performance of the X-ray, while the professional component is for the physician's interpretation. The technical component (H-fee) is subject to specific payment rules, including not being payable for hospital in-patients or for services rendered outside of a hospital setting ().
When to Use
- Use X064C for the professional interpretation of orthoroentgenograms when the diagnostic study is performed to assess limb length discrepancy.
- Use X064B for the technical performance of the study only when the service is rendered in a non-hospital setting, as it is strictly prohibited for hospital in-patients.
Common Pitfalls
- Billing X064B for hospital in-patients or for services performed within a hospital facility, which will trigger an automatic rejection per GP11.
- Failing to append the correct suffix (B for technical, C for professional) to the base code X064, leading to processing errors.
- Claiming X064B for services rendered outside of a hospital setting without maintaining the required quality assurance documentation as mandated by GP11.
Billing Tips
- Always ensure the professional interpretation (X064C) is supported by a formal report in the patient record to justify the P-fee, separate from the technical acquisition (X064B).
Effective: April 1, 2025
D. Diagnostic Radiology
DIAGNOSTIC RADIOLOGY
Diagnostic
Diagnostic Radiology
The physician claiming the technical component must maintain documentation describing the quality assurance process in accordance with professional standards ().
All insured services must be documented in the medical record to establish that an insured service was provided, the service claimed is the service that was rendered, and the service was medically necessary ().
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.