X101 – Abdomen - two or more views
OHIP Laboratory Code — DIAGNOSTIC RADIOLOGY · Schedule of Benefits
<p>A radiological examination of the abdomen involving two or more views. This service is comprised of a technical component (H fee of 22.80) and a professional component (P fee of 10.05). The professional component is for the physician's interpretation.</p><p>As per , the technical component is not eligible for payment if the service is rendered to a hospital in-patient, or an out-patient who is subsequently admitted within 24 hours for the same condition. The technical component listed with an 'H' is also not eligible for payment when rendered outside of a hospital.</p><p>Referrals from a Physician, Nurse Practitioner, or Oral and Maxillofacial Surgeon are insured under specific conditions outlined in .</p>
When to Use
- Use X101 when a patient requires a multi-view abdominal series (e.g., supine and upright) to evaluate for bowel obstruction or perforation, as opposed to the single-view X100.
- Use this code for non-elective, urgent diagnostic imaging in a hospital setting where the professional interpretation is performed by the radiologist.
Common Pitfalls
- Billing the technical component (H fee) for services rendered to hospital in-patients or patients admitted within 24 hours, which is strictly prohibited under GP11.
- Attempting to bill the technical component for services performed outside of a hospital setting, as the 'H' prefix is restricted to hospital-based technical services.
- Failing to document the specific clinical indication for the multi-view series, which is required to justify the higher complexity compared to X100.
Billing Tips
- Ensure the professional component is billed separately from the technical component if you are only providing the interpretation, as the total fee is split between the two.
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.
Ready to bill this code?
SnapBill makes OHIP billing simple — auto-filled codes, validation, and batch submission.