X069 – Foot - two or three views
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
This service provides for a diagnostic radiological examination of the foot, including two or three views. The service is comprised of two distinct, separately claimable components: - Technical Component (H): Covers the cost of the facility, equipment, and technical staff for performing the X-ray. It is only payable for services rendered in a hospital. - Professional Component (P): Covers the physician's interpretation of the images and the written report. As per , the claim for the technical component is submitted using the fee schedule code with the suffix B and the claim for the professional component is submitted using the fee schedule code with a suffix C.
When to Use
- Use X069 for standard diagnostic foot imaging requiring two or three views, such as investigating suspected metatarsal fractures or acute foot trauma.
- Use X069 when the clinical indication is limited to the foot; do not use this code if the imaging extends to include the ankle, which would require a separate or different code like X229.
Common Pitfalls
- Billing the technical component (suffix B) for services performed in a private clinic or office setting; this component is strictly reserved for hospital-based services.
- Failing to separate the claim into the professional component (suffix C) and technical component (suffix B), which will lead to rejection or audit discrepancies.
- Submitting X069 for imaging that includes the ankle; ensure the anatomical scope of the X-ray matches the code definition to avoid incorrect billing.
Billing Tips
- Always verify that the hospital facility has provided the technical equipment and staff before claiming the suffix B component to ensure compliance with the quality assurance requirements.
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.
For those diagnostic services which have both technical and professional components listed under one fee schedule code, the technical and professional components are claimed separately. The claim for the technical component is submitted using the fee schedule code with the suffix B and the claim for the professional component is submitted using the fee schedule code with a suffix C.
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