X067 – Ankle - two or three views
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
A diagnostic radiological examination of the ankle, involving two or three views. This service is comprised of a technical component (H) for performing the x-ray and a professional component (P) for its interpretation. For an examination involving four or more views, see X227.
When to Use
- Use X067 for standard ankle trauma series consisting of AP, lateral, and mortise views.
- Use X067 when a patient presents with localized ankle pain and the clinical suspicion warrants a standard 2-3 view radiographic assessment.
Common Pitfalls
- Billing X067 when four or more views are taken, which requires the use of X227 instead.
- Attempting to bill the technical component (H) for an in-patient or a patient admitted within 24 hours of the service, which is prohibited under the General Preamble.
- Submitting the professional component (P) without ensuring the technical component (H) was performed and documented according to quality assurance standards.
Billing Tips
- Ensure the requisition clearly specifies the number of views to justify the selection of X067 over X227.
- Verify that the technical component (H) is only claimed for out-patient services where the 24-hour admission rule does not apply.
Effective: April 1, 2025
D. Diagnostic Radiology
DIAGNOSTIC RADIOLOGY
Diagnostic
Diagnostic Radiology
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.
All insured services must be documented in appropriate records. The 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.
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