All codes
X066
X066 – Tibia and fibula - two views
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
Tibia and fibula including one joint, two views. This service is comprised of two components: a technical component (H fee) for performing the X-ray, and a professional component (P fee) for the interpretation. The fee listed is H: 14.90, P: 6.40.
When to Use
- Use X066 when ordering a standard two-view radiographic assessment of the tibia and fibula shaft that includes at least one adjacent joint (knee or ankle).
- Select X066 for trauma or follow-up imaging where the clinical focus is the long bones of the lower leg rather than a dedicated joint series like X226 for the ankle.
Common Pitfalls
- Billing X066 in addition to a dedicated joint X-ray (e.g., X226 for ankle) for the same limb on the same day is often flagged as unbundling; ensure the clinical necessity for both distinct studies is documented.
- Attempting to claim the 'H' (technical) component for hospital in-patients or patients admitted within 24 hours of the service will result in automatic rejection.
Billing Tips
- When billing for private office imaging, ensure you only claim the 'P' (professional) component if the technical facility is not eligible for the 'H' fee under OHIP guidelines.
- Always verify that the requisition specifies the inclusion of at least one joint, as X066 is strictly defined by the two-view requirement including a joint.
Provider Fee$0.00
Surgical Assistant Fee$16.95
Non-Anaesthetist Fee$6.40
Effective: April 1, 2025
Category
D. Diagnostic Radiology
Subcategory
DIAGNOSTIC RADIOLOGY
Service Type
Diagnostic
Code Classes
Diagnostic Radiology
Referral RequiredFrom: Physician, NursePractitioner, OralMaxillofacialSurgeon
In accordance with the Health Insurance Act, the medical record must 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.
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